Mirza Hasan, Noori Muhammad Atif Masood, Akbar Hafsa, Fichadiya Hardik, Kaur Ikwinder Preet, Sachdeva Sonali, Grewal Jagpreet, Khakwani Muhammad Zain, Levitt Howard, Chang Wang, Wasty Najam, Patton Chandler, Shah Ajay, Angi Priya, Mughal Mohsin S
Internal Medicine, Berkshire Medical Center, Pittsfield, USA.
Internal Medicine, Rutgers Health - Trinitas Regional Medical Center, Elizabeth, USA.
Cureus. 2022 Jul 11;14(7):e26741. doi: 10.7759/cureus.26741. eCollection 2022 Jul.
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.
尽管缺乏高血压会增加新感染可能性的直接证据，但高血压是已知的COVID-19患者中最常见的合并症，也是严重COVID-19感染的主要危险因素。文献综述表明，关于高血压与死亡率之间的关联，数据存在异质性。因此，高血压是否与COVID-19疾病严重程度和死亡率相关仍是一个备受关注的话题。在此，我们进行了一项多中心回顾性分析，以研究高血压作为住院COVID-19患者院内死亡的独立风险因素。这项多中心回顾性分析纳入了2020年3月1日至2020年5月31日期间住院的515例COVID-19患者。患者分为两组：高血压组和血压正常组。收集了人口统计学特征和实验室数据，并计算了两组的院内死亡率。研究人群的总体死亡率为25.3%（514例患者中的130例），其中96例（73.8%）为高血压患者，34例（26.2%）为血压正常患者（p值为0.01，统计学上无显著关联）。与非高血压患者相比，高血压患者的死亡率更高；然而，高血压患者更有可能年龄较大且患有包括肥胖、糖尿病、冠状动脉疾病、充血性心力衰竭、中风、慢性肾脏病（CKD）、慢性阻塞性肺疾病（COPD）和癌症在内的基础合并症。因此，多变量逻辑回归未能显示高血压与COVID-19死亡率之间存在任何显著关联。据我们所知，很少有研究在调整混杂变量后显示高血压与COVID-19死亡率之间存在关联。我们的研究提供了进一步的证据，即在对住院COVID-19患者的其他合并症进行调整后，高血压不是院内死亡的独立危险因素。
