Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
Department of Health Information and Management, Chungbuk National University College of Medicine, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644, Republic of Korea.
BMC Infect Dis. 2021 Feb 15;21(1):175. doi: 10.1186/s12879-021-05848-8.
While hypertension is the most common comorbid condition in patients with coronavirus disease 2019 (COVID-19) in Korea, there is a lack of studies investigating risk factors in COVID-19 patients with hypertension in Korea. In this study, we aimed to examine the effects risk factors in hypertensive Korean COVID-19 patients.
We selected patients from the database of the project #OpenData4Covid19. This information was linked to their 3-year historical healthcare data. The severity of the disease was classified into five levels. We also clustered the levels into two grades.
The risk factors associated with COVID-19 severity were old age, diabetes mellitus, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), malignancy, and renal replacement therapy. The use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) both before and after a diagnosis of COVID-19 were not associated with COVID-19 severity. A multivariate analysis revealed that old age, male sex, diabetes mellitus, and renal replacement therapy were risk factors for severe COVID-19.
The results suggest that in hypertensive patients with COVID-19, older age, male sex, a diagnosis of diabetes mellitus, and renal replacement therapy were risk factors for a severe clinical course. In addition, the use of ARBs and ACEIs before or after COVID-19 infection did not affect a patient's risk of contracting COVID-19 nor did it contribute to a worse prognosis for the disease. These results highlighted that precautions should be considered for hypertensive patients with those risk factors and do not support discontinuation of ARBs and ACEIs during COVID-19 pandemic.
在韩国，高血压是新型冠状病毒病 2019（COVID-19）患者最常见的合并症，但缺乏针对韩国 COVID-19 合并高血压患者危险因素的研究。本研究旨在探讨韩国高血压 COVID-19 患者的危险因素的影响。
我们从#OpenData4Covid19 项目的数据库中选择患者。这些信息与他们的 3 年历史医疗保健数据相关联。疾病的严重程度分为五个等级。我们还将这些等级分为两个等级。
与 COVID-19 严重程度相关的危险因素是年龄较大、糖尿病、脑血管病、慢性阻塞性肺疾病（COPD）、恶性肿瘤和肾脏替代治疗。在 COVID-19 诊断前后使用血管紧张素转换酶抑制剂（ACEIs）或血管紧张素受体阻滞剂（ARBs）与 COVID-19 严重程度无关。多变量分析显示，年龄较大、男性、糖尿病和肾脏替代治疗是 COVID-19 严重的危险因素。
研究结果表明，在 COVID-19 合并高血压的患者中，年龄较大、男性、糖尿病诊断和肾脏替代治疗是严重临床病程的危险因素。此外，在 COVID-19 感染前后使用 ARBs 和 ACEIs 既不会增加患者感染 COVID-19 的风险，也不会对疾病的预后产生不利影响。这些结果表明，应考虑对具有这些危险因素的高血压患者采取预防措施，并不支持在 COVID-19 大流行期间停止使用 ARBs 和 ACEIs。
