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[高血压对新型冠状病毒肺炎患者预后的影响]

[Effect of hypertension on outcomes of patients with COVID-19].

作者信息

Chengyi H U, Lushan Xiao, Hongbo Zhu, Yanpei Zhang, Wenfeng Zhang, Li Liu, Hong Zhu

机构信息

Department of Medical Quality Management, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2020 Nov 30;40(11):1537-1542. doi: 10.12122/j.issn.1673-4254.2020.11.01.

Abstract

OBJECTIVE

To determine the impact of hypertension on the outcomes of patients with COVID-19.

METHODS

This matched cohort study was conducted among a total 442 patients with COVID-19 admitted in Honghu People's Hospital and First Affiliated Hospital of Nanchang University between January 1 to March 18, 2020, including 61 patients with hypertension and 381 normotensive patients. To minimize the effects of the confounding factors including age, gender and other comorbidities, we excluded patients with comorbidities other than hypertension, and matched the patients with and without hypertension for age and gender at a 1:1 ratio. We analyzed the clinical characteristics, laboratory findings and clinical outcomes of in 32 matched pairs of patients with and without hypertension.

RESULTS

Compared with the normotensive patients, COVID-19 patients with hypertension were more likely to develop bacterial infections (=0.002) and had higher neutrophil counts (=0.007), neutrophil/lymphocyte ratio (=0.045), and lactate dehydrogenase levels (=0.035). A greater proportion of patients had bilateral patchy opacities on chest CT (=0.012) in the hypertension group than in the normotensive group. COVID-19 patients with hypertension group were more likely to receive antibiotics (=0.035) and corticosteroid therapies (=0.035).

CONCLUSION

Hypertension increases the risk of bacterial infection in patients with COVID-19. Hypertensive patients with COVID-19 have higher neutrophil counts and neutrophil/ lymphocyte ratios and are more likely to require treatment with antibiotics. Hypertensive patients with COVID-19 should therefore take cautions to avoid bacterial infections.

摘要

目的

确定高血压对新型冠状病毒肺炎(COVID-19)患者预后的影响。

方法

本匹配队列研究于2020年1月1日至3月18日在洪湖市人民医院和南昌大学第一附属医院收治的442例COVID-19患者中进行,其中包括61例高血压患者和381例血压正常患者。为尽量减少年龄、性别和其他合并症等混杂因素的影响,我们排除了除高血压以外有其他合并症的患者,并按1:1的比例对有高血压和无高血压的患者进行年龄和性别的匹配。我们分析了32对匹配的有高血压和无高血压患者的临床特征、实验室检查结果及临床结局。

结果

与血压正常的患者相比,患有高血压的COVID-19患者更易发生细菌感染(P=0.002),且中性粒细胞计数(P=0.007)、中性粒细胞/淋巴细胞比值(P=0.045)和乳酸脱氢酶水平(P=0.035)更高。高血压组胸部CT显示双侧斑片状模糊影的患者比例高于血压正常组(P=0.012)。患有高血压的COVID-19患者组更有可能接受抗生素治疗(P=0.035)和皮质类固醇治疗(P=0.035)。

结论

高血压增加了COVID-19患者发生细菌感染的风险。患有COVID-19的高血压患者中性粒细胞计数和中性粒细胞/淋巴细胞比值更高,且更有可能需要抗生素治疗。因此,患有COVID-19的高血压患者应注意避免细菌感染。

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