39 CHARACTERISTICS AND MORTALITY IN HYPERTENSIVE COVID-19 PATIENTS AT A DISTRICT HOSPITAL IN NORTH JAKARTA: A CROSS-SECTIONAL STUDY

Abstract

Background: The characteristics and clinical course of Coronavirus disease 2019 (COVID-19) patients treated in a district hospital, particularly those with comorbidities like hypertension, may differ from patients who were treated in a tertiary hospital. A better understanding of the characteristics and clinical courses of those patients is necessary to establish an optimal management strategy. Objective: This study aims to describe the characteristics and to identify the predictors of mortality in hypertensive COVID-19 patients in a district hospital in North Jakarta. Methods: A cross-sectional study was conducted on 192 hypertensive COVID-19 patients admitted between January and November 2021. Exclusion criteria were pregnancy and referral to another center. Demographic and clinical characteristics of the patients were obtained by reviewing medical records. Binary logistic regression analysis was performed to evaluate the associations between mortality and age, sex, comorbidities such as diabetes mellitus, heart disease, chronic kidney disease (CKD), cerebrovascular disease and pulmonary tuberculosis as well as C-reactive protein (CRP), D-dimer level at admission. The cut-off value of CRP and D-dimer level associated with mortality were determined using ROC analysis. Results: Hypertensive COVID-19 patients were mostly male with an average age of 56.6 years (standard deviation 10.9). Mild, moderate, severe, and critical COVID-19 were found in 23.4%, 23.4%, 35.9%, and 17.2% of the patients, respectively. The majority of the participants (55.2%) had at least one comorbidity other than hypertension. The overall mortality rate was 15.1%. Heart disease (odds ratio 4.01, 95% CI 1.11 to 13.9; p = 0.029), CKD (OR 10.41, 95% CI 2.12 to 51.13; p = 0.004) and an elevated CRP level (OR 10.98, 95% CI 3.32 — 36.32; p < 0.001) were associated with a higher risk of mortality in hypertensive COVID-19 patients. Conclusion: Hypertensive COVID-19 patients had a high frequency of comorbidities and similar clinical characteristics to those reported elsewhere. Hypertensive COVID-19 patients with heart disease, CKD, and elevated CRP levels were at higher risk of mortality and therefore may benefit from more aggressive therapy.