Association of Hypertension with All-Cause Mortality among Hospitalized Patients with COVID-19

Abstract

It is unclear to which extent the higher mortality associated with hypertension in the coronavirus disease (COVID-19) is due to its increased prevalence among older patients or to specific mechanisms. Cross-sectional, observational, retrospective multicenter study, analyzing 12226 patients who required hospital admission in 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics of survivors versus non-survivors. The mean age of the study population was 67.5 ± 16.1 years, 42.6% were women. Overall, 2630 (21.5%) subjects died. The most common comorbidity was hypertension (50.9%) followed by diabetes (19.1%), and atrial fibrillation (11.2%). Multivariate analysis showed that after adjusting for gender (males, OR: 1.5, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, p = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 0.035). The preexisting condition of hypertension had an independent prognostic value for all-cause mortality in patients with COVID-19 who required hospitalization. ARBs showed a lower risk of lethality in hypertensive patients than other antihypertensive drugs.

High versus standard doses of corticosteroids in severe COVID-19: a retrospective cohort study

“…Although some differences in baseline characteristics were detected (male gender, older age, and comorbidities were significantly more common among the HD group), appropriate adjustments were performed, concomitant treatments during admission were equally administered, and sensitivity analyses reinforced the robustness of our results. In addition, despite all patients had a severe COVID-19, overall mortality (24.8%) was consistent with that reported from previous studies in the early stages of the pandemics in Europe among hospitalized subjects [38,39], suggesting a lower risk of selection bias.…”

Meta-Analysis of Atrial Fibrillation in Patients With COVID-19

“…Nine hundred and sixteen potentially relevant studies were screened according to the inclusion and exclusion criteria. Finally, 23 studies with 108,745 COVID-19 patients 1 , 2 , 3 , 4 , 5 , 6 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 were eligibly included in the present quantitative meta-analysis. The study characteristics are summarized in Table 1 .…”

Renin–angiotensin system blockers, risk of SARS-CoV-2 infection and outcomes from CoViD-19: systematic review and meta-analysis

“…These findings are reassuring, despite the high probability of residual confounding in these analyses. 30 Further support for this interpretation, comes from the Chinese studies we included which reported an additional category of severe SARS-CoV-2-related pneumonia/CoViD-19 (independently of whether patients were admitted to ITU or required ventilation), reflecting local guidelines for the diagnosis and treatment of new coronavirus pneumonia. 31 Some of the Chinese studies showed larger effects, as indicated by Egger’s test.…”