Abstract

BackgroundThe country of Spain has one of the highest incidences of COVID-19, with more than 1,000,000 cases as of the end of October 2020. Patients with a history of chronic conditions, obesity, and cancer are at greater risk from COVID-19; moreover, concerns surrounding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin type II receptor blockers (ARBs) and its relationship to COVID-19 susceptibility have increased since the beginning of the pandemic.ObjectiveThe objectives of this study were to compare the characteristics of patients diagnosed with COVID-19 to those of patients without COVID-19 in primary care; to determine the risk factors associated with the outcome of mortality; and to determine the potential influence of certain medications, such as ACEIs and ARBs, on the mortality of patients with COVID-19.MethodsAn observational retrospective study of patients diagnosed with COVID-19 in the Catalan Central Region of Spain between March 1 and August 17, 2020, was conducted. The data were obtained from the Primary Care Services Information Technologies System of the Catalan Institute of Health in Barcelona, Spain.ResultsThe study population included 348,596 patients (aged >15 years) registered in the Primary Care Services Information Technologies System of the Catalan Central Region. The mean age of the patients was 49.53 years (SD 19.42), and 31.17% of the patients were aged ≥60 years. 175,484/348,596 patients (50.34%) were women. A total of 23,844/348,596 patients (6.84%) in the population studied were diagnosed with COVID-19 during the study period, and the most common clinical conditions of these patients were hypertension (5267 patients, 22.1%) and obesity (5181 patients, 21.7%). Overall, 2680/348,596 patients in the study population (0.77%) died during the study period. The number of deaths among patients without COVID-19 was 1825/324,752 (0.56%; mean age 80.6 years, SD 13.3), while among patients diagnosed with COVID-19, the number of deaths was 855/23,844 (3.58%; mean age 83.0 years, SD 10.80) with an OR of 6.58 (95% CI 6.06-7.15).ConclusionsWe observed that women were more likely to contract COVID-19 than men. In addition, our study did not show that hypertension, obesity, or being treated with ACEIs or ARBs was linked to an increase in mortality in patients with COVID-19. Age is the main factor associated with mortality in patients infected with SARS-CoV-2.

Highlights

  • A highly pathogenic coronavirus, SARS-CoV-2, was first described in Wuhan in late December 2019 and has since spread worldwide [1,2]

  • Our study did not show that hypertension, obesity, or being treated with angiotensin-converting enzyme inhibitor angiotensin type II receptor blockers (ARBs) (ACEI) or ARBs was linked to an increase in mortality in patients with COVID-19

  • There is no significant difference in age between patients with and without COVID-19, age is the main factor associated with mortality in patients with COVID-19, along with male sex, diabetes, dyslipidemia and heart failure

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Summary

Introduction

A highly pathogenic coronavirus, SARS-CoV-2, was first described in Wuhan in late December 2019 and has since spread worldwide [1,2]. At the beginning of the pandemic, studies pointed to a protective relationship between smoking and COVID-19 and suggested that nicotine could have a protective effect against COVID-19 due to its minor anti-inflammatory properties. This effect could even be more marked considering that it could be masked by smoking-related toxicity and cessation of smoking when patients are severely ill with COVID-19 [9,10,11]. Patients with a history of chronic conditions, obesity, and cancer are at greater risk from COVID-19; concerns surrounding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin type II receptor blockers (ARBs) and its relationship to COVID-19 susceptibility have increased since the beginning of the pandemic

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