This has potentially important implications in clinical practice. A recent report from Italy suggests that the prevalence of arterial hypertension is significantly higher amongst COVID-19 patients admitted to ICU who do not survive. 7 Our study has several limitations related to the observational nature of the studies reviewed with all inherent biases. Few investigations have examined the link between arterial hypertension and ICU admission in COVID-19 patients, limiting the number of the studies included in the metaanalysis. No formal definition of arterial hypertension was given in the included studies. The need for ICU admission may have depended on local resources that are often different between units. No adjustments for confounders were made for other risk factors such as age or other baseline cardiovascular or chronic comorbidities. All included studies were performed in China, so we cannot exclude significant differences between other populations. Because we considered only published studies in English, we cannot exclude missing some investigations with interesting findings published only in Chinese in particular. In our analysis, the degree of increased risk of ICU admission in hypertensive patients was strongly influenced by a single study, that of Guan and colleagues. 2 The identification of those predictors indicating a need for intensive care admission could be helpful in managing the early phase of the pandemic both for clinical and ICU management. However, our results should be considered preliminary, and further research is necessary to confirm our findings. 8 Declarations of interest The authors declare that they have no conflicts of interest.

Spontaneous subarachnoid haemorrhage is characterized by extravasation of blood into the subarachnoid space without a preceding trauma. The leading cause is a ruptured intracranial aneurysm. Serious neurologic complications can occur, such as rebleeding, cerebral vasospasm and delayed cerebral ischemia. Subarachnoid haemorrhage is a serious condition with a high mortality rate and those who survive often suffer long-term consequences. Prevention of rebleeding by aneurysm repair is essential and guidelines recommend this procedure should be done as soon as possible or within 72 hours. Management requires intensive care with emphasis on accurate blood pressure control, maintaining normal fluid and electrolyte balance and monitoring the level of consciousness. All patients should be treated with the calcium channel blocker nimodipine to reduce the risk of vasospasm and delayed cerebral ischemia which are among the most serious complications of subarachnoid haemorrhage.

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