Abstract

Introduction: The pandemic of COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 infection. Although clinical data is limited, studies published so far raise concerns about an association between hypertension and worse clinical outcomes in COVID-19. Our aim was to assess the association between hypertension and mortality in COVID-19 patients. Methods: A systematic electronic search was performed in PubMed, Embase, and Google Scholar. Retrospective studies with original COVID-19 hospitalized patient data and reporting prevalence of hypertension was included in our study. Pooled analysis using a random-effects model was performed to look at the association between hypertension and mortality. Results: 22 studies from 8 countries with over 11,000 patients were included in our analysis. Hypertension was the most prevalent comorbidity in hospitalized COVID-19 patients (42%), followed by diabetes mellitus (23%)(Figure 1). Hypertension by itself was associated with higher rates of mortality (Figure 2). Other less prevalent comorbidities include non-hypertensive cardiovascular disease (11%), CKD (6%), CVA (5%), COPD (4.3%). Conclusion: Hypertension is the most prevalent comorbidity in hospitalized COVID-19 patients, followed by diabetes mellitus and was found to be significantly associated with higher rates of mortality. Surprisingly, hypertension is significantly more common than COPD in this population. The reason for this is unclear, there is no evidence currently that hypertension is directly related to mortality in this population. More randomized studies are needed to assess the effect of hypertension on mortality in COVID-19 patients.

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