43 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 district hospitals, particularly those with comorbidities like hypertension, may differ from patients treated in tertiary hospitals. Better understanding of such patients is necessary to establish an optimal management strategy. Objective: This study aims to describe the characteristics and identify mortality predictors 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 in January—November 2021. Exclusion criteria were pregnancy and referral to another center. Binary logistic regression analysis was performed to evaluate the associations between mortality and age, sex, diabetes mellitus, heart diseases, chronic kidney disease (CKD), cerebrovascular disease, pulmonary tuberculosis and C-reactive protein (CRP) and 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%, respectively. Most 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—13.9; p=0.029), CKD (OR 10.41, 95%CI 2.12—51.13; p=0.004) and elevated CRP level (OR 10.98, 95%CI 3.32—36.32; p<0.001) were associated with a higher risk of mortality. Conclusion: Hypertensive COVID-19 patients had a high frequency of comorbidities and similar characteristics to those reported elsewhere. Patients with heart disease, CKD, and elevated CRP levels were at higher risk of mortality and therefore may benefit from a more aggressive therapy.