Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines.
Eur J Med Res. 2023 Feb 3;28(1):62. doi: 10.1186/s40001-022-00969-5.
To describe the association between hypertension and clinical outcomes in a cohort of patients with coronavirus disease 2019 (COVID-19).
Retrospective cohort study.
Thirty-seven (37) hospitals in the Philippines.
10,881 patients admitted for COVID-19 from February to December 2020.
Among the 10,881 patients included in the Philippine CORONA Study, 3647 (33.5%) had hypertension. On regression analysis adjusted for confounders (age group, sex, smoking history, diabetes, chronic cardiac disease, chronic kidney disease, chronic respiratory disease, chronic neurologic disease, chronic liver disease, HIV/AIDS, and malignancy), patients with hypertension had significantly greater odds of in-hospital mortality (OR 1.33, 95% CI 1.17-1.52), respiratory failure (OR 1.99, 95% CI 1.75-2.28), ICU admission (OR 2.16, 95% CI 1.90-2.45) and severe/critical disease (OR 1.57, 95% CI 1.41-1.75), compared to patients without hypertension. The time-to-event analysis with confounder adjustment also showed that hypertension was significantly associated with shorter time-to-event outcomes of in-hospital mortality (HR 1.13, 95% CI 1.01-1.26), respiratory failure (HR 1.86, 95% CI 1.65-2.10), and ICU admission (HR 1.99, 95% CI 1.76-2.23).
Our analysis of nationwide data confirmed previous findings that hypertension is an independent risk factor for worse clinical outcomes among patients hospitalized for COVID-19, with increased odds of in-hospital mortality, respiratory failure, ICU admission, and severe/critical COVID-19. More specific studies should be done to elucidate the impact of hypertension characteristics, such as chronicity, severity, drug therapy, and level of control on these clinical outcomes.
描述 2019 年冠状病毒病（COVID-19）患者队列中高血压与临床结局的关系。
回顾性队列研究。
菲律宾的 37 家医院。
2020 年 2 月至 12 月期间因 COVID-19 住院的 10881 例患者。
在菲律宾 CORONA 研究中纳入的 10881 例患者中，3647 例（33.5%）患有高血压。在校正混杂因素（年龄组、性别、吸烟史、糖尿病、慢性心脏疾病、慢性肾脏疾病、慢性呼吸疾病、慢性神经疾病、慢性肝脏疾病、HIV/AIDS 和恶性肿瘤）后进行回归分析，高血压患者院内死亡率（OR 1.33，95%CI 1.17-1.52）、呼吸衰竭（OR 1.99，95%CI 1.75-2.28）、入住 ICU（OR 2.16，95%CI 1.90-2.45）和严重/危重病（OR 1.57，95%CI 1.41-1.75）的可能性显著更高，与无高血压的患者相比。调整混杂因素的时间事件分析也表明，高血压与院内死亡率（HR 1.13，95%CI 1.01-1.26）、呼吸衰竭（HR 1.86，95%CI 1.65-2.10）和 ICU 入住（HR 1.99，95%CI 1.76-2.23）的时间事件结局显著相关。
我们对全国范围数据的分析证实了先前的发现，即高血压是 COVID-19 住院患者临床结局恶化的独立危险因素，院内死亡率、呼吸衰竭、入住 ICU 和严重/危重症 COVID-19 的可能性增加。应进行更具体的研究，以阐明高血压特征（如慢性、严重程度、药物治疗和控制水平）对这些临床结局的影响。
