Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Infectious Disease, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
J Res Health Sci. 2022 Dec;22(4):e00565. doi: 10.34172/jrhs.2022.100.
Hypertension and diabetes are common comorbidities in patients with COVID-19 and could be influencing the mortality of such patients. The present study aimed to evaluate the effects of hypertension alone and in comorbidity with diabetes on the death within 30 days among inpatients with COVID-19 in presence of well-known determinates of COVID-19 death.
A case-control study.
Four groups of COVID-19 inpatients including controls, diabetes alone, hypertension alone, and hypertension and diabetes comorbidities were defined. Each study groups did not have underlying diseases other than hypertension and diabetes. Demographic and general characteristics, underlying diseases, and hospital course events were extracted from medical records. The outcome of interest was alive at discharge/ death within 30 days after admission. Multivariable binary logistic analysis was employed to estimate the effect measures.
The number of death within 30 days among controls (n=1359), diabetes alone (159), hypertension alone (406) and hypertension and diabetes comorbidities (188) were 12.68%, 15.72%, 20.74% and 26.74%, respectively. According to three multivariable analyses after adjusting older age, hospital length of stay, and intensive care unit (ICU) admission separately, the odds of death within 30 days in COVID-19 patients with having hypertension and diabetes comorbidities was 1.58, 2.13 and 1.91 times of patients without such comorbidities, respectively (<0.015). The effect of hypertension alone was also significant after adjusting hospital length of stay and ICU admission but not for older age.
Our results suggest that comorbidities, such as hypertension and diabetes may be associated with COVID-19-related deaths independent of other underlying diseases, older age, and adverse hospital course events.
高血压和糖尿病是 COVID-19 患者常见的合并症,可能影响此类患者的死亡率。本研究旨在评估高血压单独存在和与糖尿病合并存在对 COVID-19 住院患者 30 天内死亡的影响,同时考虑 COVID-19 死亡的已知决定因素。
病例对照研究。
将 COVID-19 住院患者分为四组,包括对照组、糖尿病组、高血压组和高血压合并糖尿病组。每个研究组除高血压和糖尿病外,没有其他基础疾病。从病历中提取人口统计学和一般特征、基础疾病和住院过程事件。感兴趣的结局是出院时存活/入院后 30 天内死亡。采用多变量二项逻辑回归分析估计效应量。
对照组(n=1359)、糖尿病组(159)、高血压组(406)和高血压合并糖尿病组(188)在 30 天内死亡的人数分别为 12.68%、15.72%、20.74%和 26.74%。根据调整年龄、住院时间和重症监护病房(ICU)入住率后的三项多变量分析,COVID-19 患者合并高血压和糖尿病的 30 天内死亡风险分别为无此类合并症患者的 1.58 倍、2.13 倍和 1.91 倍(<0.015)。调整住院时间和 ICU 入住率后,高血压单独存在的影响也具有统计学意义,但与年龄无关。
我们的结果表明,高血压和糖尿病等合并症可能与 COVID-19 相关的死亡独立于其他基础疾病、年龄较大和不良的住院过程事件有关。