Clinical characteristics and fatal outcomes of hypertension in patients with severe COVID-19

Xiaocheng Cheng,Lei Gao,Dongying Zhang,Guoqiang Cai,Xuesong Wen,Dan Jiang,Shu Qin,Jianzhong Zhou,Min Sun

doi:10.18632/aging.104019

Abstract

The aim of this study is to investigate clinical characteristics and fatal outcomes of hypertension as well as the role of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) use in patients with severe coronavirus disease 2019 (COVID-19). A total of 220 (female: 51.8%) patients with severe COVID-19 were included. The mean age of included patients was 59.5 years and 70 (31.8%) patients had a history of hypertension. There were 23 patients (32.9%) receiving ACEI/ARB therapy. Patients with hypertension were older and had more comorbidities, and were more likely to suffer from severe inflammatory response and acute cardiac injury. Moreover, patients with hypertension were associated with significantly higher risk of in-hospital mortality than patients without hypertension. After adjustment of potential confounders, the independent correlation was still observed. In addition, ACEI/ARB users were associated with lower level of high-sensitivity cardiac troponin I and creatinine kinase–myocardial band, and lower risk of acute cardiac injury than ACEI/ARB non-users. In conclusion, patients with hypertension were more likely to suffer from severe inflammatory response, acute cardiac injury and had high risk of in-hospital mortality in severe COVID-19. The use of ACEI/ARB may protect patients with COVID-19 from acute cardiac injury.

Highlights

The coronavirus disease 2019 (COVID-19) has become a worldwide pandemic [1,2,3,4]
The major findings of our study are the following: (i) hypertension is highly prevalent among patients with severe COVID-19; (ii) patients with hypertension were more likely to suffer from severe inflammatory and acute cardiac injury; (iii) hypertension is an independent risk factor of in-hospital mortality; (iv) the use of angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) may protect COVID-19 from acute cardiac injury
We found that patients with hypertension were more likely to suffer from acute cardiac injury

Summary

Introduction

The coronavirus disease 2019 (COVID-19) has become a worldwide pandemic [1,2,3,4]. It has been shown that hypertension was one of the most distinctive comorbidities in COVID-19 infection. The study by Guan and colleagues enrolled 1099 patients with confirmed COVID-19, 23% of whom had a history of hypertension in severe cases [1]. Richardson et al reported that hypertension was the most common comorbidities in COVID-19, reaching to 56.6% [4]. It is unclear about the clinical characteristics of hypertension infected COVID-19, and whether hypertension is associated with poor clinical outcomes is less clear

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Conclusion