GENDER DIFFERENCES IN COVID-19 PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Objective: To evaluate the gender differences in covid-19 patients with arterial hypertension. Design and method: This is a retrospective observational study comparing the association by gender of hypertensive status and with mortality among hospitalized patients with COVID-19. All patients admitted to our Hospitals, from 12 March to 12 April 2020 with confirmed COVID-19 were included in this study. Patients with COVID-19 included in this study were diagnosed according to World Health Organization interim guidance. Patients’ demographic characteristics and clinical data (symptoms, comorbidities, laboratory findings, and outcomes) during hospitalization were collected from electronic medical records. The primary endpoint was all-cause mortality by gender during hospitalization. Other endpoints included the time elapsed between onset of symptoms and discharge, the rates of use of invasive mechanical ventilation, and the differences by gender in the treatment. The diagnosis of hypertension was given by the patient's physician prior to the infection with SARS-CoV-2. Results: In total, 877 consecutive hospitalized patients with confirmed COVID-19 were enrolled in the study. The median time from symptom onset to hospitalization was 4.6 for men and 2.6 days for women (p < 0.05). Among these patients, 58% had a medical history of hypertension (57% men and 46% for women), p < 0.05. The spectrum of symptoms of COVID-19 at admission between the two cohorts did not differ significantly. A total of (15.0%) patients died in the hypertension cohort (14% for men and 16% for women; p ns) In particular, patients with hypertension had the propensity to develop more severe/critical COVID-19 disease (P for trend < 0.001) and were more likely to receive invasive mechanical ventilation (P < 0.001). Conclusions: Patients with COVID-19 and hypertension have been reported to have an increased risk of adverse outcomes. In particular female patients with hypertension require intensive care (16% vs 11% for men, p < 0.05) but no differences by gender for mortality rate we report. As described above, these data showed that hypertensive patients are at the highest risk for outcomes adverse. To further verify our results, as well as this hypothesis, we have also designed a randomized controlled trial.