Hypertension and mortality in SARS-COV-2 infection: A meta-analysis of observational studies after 2 years of pandemic

D’Elia, Lanfranco; Giaquinto, Alfonso; Zarrella, Aquilino Flavio; Rendina, Domenico; Idelson, Paola Iaccarino; Strazzullo, Pasquale; Galletti, Ferruccio

doi:10.1016/j.ejim.2022.11.018

Cited by 14 publications

(8 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results on the pooled adjusted risk ratios for diabetes and hypertension in relation to COVID-19 mortality are consistent with the summary RR estimates adjusted for multiple confounders reported in recently published meta-analyses with inclusion of studies published as of 2022 2 50 51 56. Therefore, our findings provide further evidence and support on the independent effects and highlighted importance of possible confounding effects for the association of diabetes and hypertension with COVID-19 mortality.…”

Section: Discussionsupporting

confidence: 91%

Associations of diabetes, hypertension and obesity with COVID-19 mortality: a systematic review and meta-analysis

Li,

Islam,

Gutierrez

et al. 2023

BMJ Glob Health

View full text Add to dashboard Cite

IntroductionDespite a growing body of scholarly research on the risks of severe COVID-19 associated with diabetes, hypertension and obesity, there is a need for estimating pooled risk estimates with adjustment for confounding effects. We conducted a systematic review and meta-analysis to estimate the pooled adjusted risk ratios of diabetes, hypertension and obesity on COVID-19 mortality.MethodsWe searched 16 literature databases for original studies published between 1 December 2019 and 31 December 2020. We used the adapted Newcastle-Ottawa Scale to assess the risk of bias. Pooled risk ratios were estimated based on the adjusted effect sizes. We applied random-effects meta-analysis to account for the uncertainty in residual heterogeneity. We used contour-funnel plots and Egger’s test to assess possible publication bias.ResultsWe reviewed 34 830 records identified in literature search, of which 145 original studies were included in the meta-analysis. Pooled adjusted risk ratios were 1.43 (95% CI 1.32 to 1.54), 1.19 (95% CI 1.09 to 1.30) and 1.39 (95% CI 1.27 to 1.52) for diabetes, hypertension and obesity (body mass index ≥30 kg/m2) on COVID-19 mortality, respectively. The pooled adjusted risk ratios appeared to be stronger in studies conducted before April 2020, Western Pacific Region, low- and middle-income countries, and countries with low Global Health Security Index scores, when compared with their counterparts.ConclusionsDiabetes, hypertension and obesity were associated with an increased risk of COVID-19 mortality independent of other known risk factors, particularly in low-resource settings. Addressing these chronic diseases could be important for global pandemic preparedness and mortality prevention.PROSPERO registration numberCRD42021204371.

show abstract

Section: Discussionsupporting

confidence: 91%

Associations of diabetes, hypertension and obesity with COVID-19 mortality: a systematic review and meta-analysis

Li,

Islam,

Gutierrez

et al. 2023

BMJ Glob Health

View full text Add to dashboard Cite

show abstract

“…We are particularly interested in the discussion pertaining to the association between hypertension and severe COVID-19, where the authors concluded that there is currently mixed evidence on the risk of severe COVID-19 in patients with hypertension, upon reviewing the published findings about the association. We agree with the authors in which the association between hypertension and severe COVID-19 may not be straightforward, and this is indeed exemplified in a recently published systematic review and meta-analysis [ 2 ]. In the systematic review and meta-analysis [ 2 ], pre-existing hypertension was significantly associated with mortality due to COVID-19, both in unadjusted (hazard ratio = 2.58; 95% confidence interval 1.66 to 4.02) and adjusted models (hazard ratio = 1.55; 95% confidence interval 1.22 to 1.97), but with significant heterogeneity in both models (I 2 = 97 and 89%).…”

supporting

confidence: 90%

“…We agree with the authors in which the association between hypertension and severe COVID-19 may not be straightforward, and this is indeed exemplified in a recently published systematic review and meta-analysis [ 2 ]. In the systematic review and meta-analysis [ 2 ], pre-existing hypertension was significantly associated with mortality due to COVID-19, both in unadjusted (hazard ratio = 2.58; 95% confidence interval 1.66 to 4.02) and adjusted models (hazard ratio = 1.55; 95% confidence interval 1.22 to 1.97), but with significant heterogeneity in both models (I 2 = 97 and 89%). In addition, the association disappeared when the results adjusted for crucial and strong predictors of mortality in patients with COVID-19 (e.g., body weight).…”

supporting

confidence: 90%

Hypertension and severe COVID-19

2023

View full text Add to dashboard Cite

“…As they emphasized [ 1 ], the recent meta-analysis showed that the association of hypertension with COVID-19 mortality in crude analysis disappeared after adjustment with strong predictors of mortality [ 3 ], supporting the non-straightforward relationship between these two disorders. The importance of appropriate assessment and adjustment of crucial risk factors has also been highlighted by the findings of the CAPACITY-COVID registry [ 4 ].…”

mentioning

confidence: 99%