Hypertension as an Independent Risk Factor for In-Patient Mortality in Hospitalized COVID-19 Patients: A Multicenter Study

Abstract

Despite the lack of direct evidence that hypertension increases the likelihood of new infections, hypertension is known to be the most common comorbid condition in COVID-19 patients and also a major risk factor for severe COVID-19 infection. The literature review suggests that data is heterogeneous in terms of the association of hypertension with mortality. Hence, it remains a topic of interest whether hypertension is associated with COVID-19 disease severity and mortality. Herein, we perform a multicenter retrospective analysis to study hypertension as an independent risk for in-hospital mortality in hospitalized COVID-19 patients. This multicenter retrospective analysis included 515 COVID-19 patients hospitalized from March 1, 2020 to May 31, 2020. Patients were divided into two groups: hypertensive and normotensive. Demographic characteristics and laboratory data were collected, and in-hospital mortality was calculated in both groups. The overall mortality of the study population was 25.3% (130 of 514 patients) with 96 (73.8%) being hypertensive and 34 (26.2%) being normotensive (p-value of 0.01, statistically non-significant association). The mortality rate among the hypertensive was higher as compared to non-hypertensive; however, hypertensive patients were more likely to be old and have underlying comorbidities including obesity, diabetes mellitus, coronary artery disease, congestive heart failure, stroke, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and cancer. Therefore, multivariable logistic regression failed to show any significant association between hypertension and COVID-19 mortality. To our knowledge, few studies have shown an association between hypertension and COVID-19 mortality after adjusting confounding variables. Our study provides further evidence that hypertension is not an independent risk factor for in-hospital mortality when adjusted for other comorbidities in hospitalized COVID-19 patients.

Severity Status of COVID-19 and Its Associated Factors at the Nyarugenge Treatment Center in Rwanda

“…A multicenter study done by Mirza et al on the effect of lone hypertension for severe COVID-19 status revealed that hypertension was not an independent risk factor for in-hospital death after being adjusted for other comorbidities in COVID-19 patients [23]. Although it is hard to tell, previous studies still unanswered whether the stage of hypertension or diabetes with each case is controlled or uncontrolled, or whether more than one comorbidity, stage of the disease, or its complications lead to severe condition of COVID-19 [22,24].…”

Evaluation of Clinical Manifestations, Pattern of Involvement, and Surgical Outcomes in Patients with Post Covid-19 Head and Neck Mucormycosis Infection among Patients Admitted To Namazi Hospital, Shiraz, Iran (2021-2022)

“…Fifty percent of patients with HTN died, and the P -value of 0.071 indicates a potential trend towards a difference in mortality, but it is not statistically significant. The literature review found that the association between hypertension and mortality is heterogeneous 35 , 36 . More research is needed to determine the exact role of hypertension in COVID-19 disease severity and mortality.…”

Persistence of SARS-CoV-2 IgG Antibody Response among South African Adults: A Prospective Cohort Study

“…Ageing and chronic comorbidities have been identified as key risk factors for SARS-CoV-2 infection [ 7 ]. Furthermore, diabetes mellitus (DM), hypertension, obesity and cardiovascular diseases have been identified as the most predominant comorbidities among individuals infected with SARS-CoV-2 [ 7 , 8 , 9 , 10 ]. It has been shown that these comorbidities are risk factors for poor outcome and mortality in individuals infected with SARS-CoV-2 [ 8 , 10 , 11 ].…”

“…Furthermore, diabetes mellitus (DM), hypertension, obesity and cardiovascular diseases have been identified as the most predominant comorbidities among individuals infected with SARS-CoV-2 [ 7 , 8 , 9 , 10 ]. It has been shown that these comorbidities are risk factors for poor outcome and mortality in individuals infected with SARS-CoV-2 [ 8 , 10 , 11 ]. The mechanism in which these comorbidities worsen COVID-19 outcomes may involve immune and inflammatory responses, modulated by hyperglycaemia and the renin–angiotensin system [ 12 , 13 , 14 , 15 ].…”