Hypertension in patients hospitalized with COVID-19 in Wuhan, China: A single-center retrospective observational study

Abstract

Objectives: It is unclear whether patients with hypertension are more likely to be infected with SARS-COV-2 than the general population and whether there is a difference in the severity of COVID-19 pneumonia in patients who have taken ACEI/ARB drugs to lower blood pressure compared to those who have not. Methods: This observational study included data from all patients with clinically confirmed COVID-19 who were admitted to the Hankou Hospital, Wuhan, China between January 5 and March 8, 2020. Data were extracted from clinical and laboratory records. Follow-up was cutoff on March 8, 2020. Results: A total of 274 patients, 75 with hypertension and 199 without hypertension, were included in the analysis. Patients with hypertension were older and were more likely to have pre-existing comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease than patients without hypertension. Moreover, patients with hypertension tended to have higher positive COVID-19 PCR detection rates. Patients with hypertension who had previously taken ACEI/ARB drugs for antihypertensive treatment have an increased tendency to develop severe pneumonia after infection with SARS-COV-2 (P = 0.064). Conclusions: COVID-19 patients with hypertension were significantly older and were more likely to have underlying comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease. Patients with hypertension who had taken ACEI/ARB drugs for antihypertensive treatment have an increased tendency to develop severe pneumonia after infection with SARS-COV-2. In future studies, a larger sample size and multi-center clinical data will be needed to support our conclusions.

Use of inhibitors of the renin‐angiotensin system in hypertensive patients and COVID‐19 severity: A systematic review and meta‐analysis

“…All of the selected studies were published in 2020 and were all of observational nature 17‐34 . In seven studies, the outcome that matched our research question was death 17,20,21,26‐28,31 ; in two studies, severe pneumonia 23,34 ; in three studies, critical or severe pneumonia 18,19,32 ; in one study, death or critical or severe pneumonia 33 ; in one study, severe pneumonia or death 24 ; and in one study, death, admission to ICU or mechanical ventilation requirement 25 .…”

A systematic review and meta-analysis to evaluate the clinical outcomes in COVID -19 patients on angiotensin converting enzyme inhibitors or angiotensin receptor blockers

“…Further, abstracts of 98 articles were read and subsequently, the full text of 41 articles were reviewed. Of these, sixteen articles were shortlisted which compared the clinical and/or mortality outcomes of COVID-19 patients on ACEI or ARB with non-users [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Finally, these sixteen studies were included for review and out of these, nine and five studies were included in the meta-analysis of mortality and severity outcomes in COVID-19 patients on ACEI/ARB, respectively.…”

“…et al found a slightly lower rate of severe outcomes which included admission to the intensive care unit, the use of noninvasive or invasive mechanical ventilation, or death in patients on ACEI/ARB (24.8%) versus no ACEI/ARB (24.9%). [12,13,15,16,19,20,[23][24][25][26][27]. (Table 2) On the contrary, Guo [13,23].…”

Renin-angiotensin system inhibitors and severity of SARS-CoV-2 infection: a meta-analysis

“…After screening 343 citations, 13 observational studies were included (Figure 1) [18][19][20][21][22][23][24][25][26][27][28][29][30], combining to a total sample of 14,364 participants. The characteristics of included studies are summarized in Table 1.…”