Abstract
BackgroundWhile hypertension is the most common comorbid condition in patients with coronavirus disease 2019 (COVID-19) in Korea, there is a lack of studies investigating risk factors in COVID-19 patients with hypertension in Korea. In this study, we aimed to examine the effects risk factors in hypertensive Korean COVID-19 patients.MethodsWe selected patients from the database of the project #OpenData4Covid19. This information was linked to their 3-year historical healthcare data. The severity of the disease was classified into five levels. We also clustered the levels into two grades.ResultsThe risk factors associated with COVID-19 severity were old age, diabetes mellitus, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), malignancy, and renal replacement therapy. The use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) both before and after a diagnosis of COVID-19 were not associated with COVID-19 severity. A multivariate analysis revealed that old age, male sex, diabetes mellitus, and renal replacement therapy were risk factors for severe COVID-19.ConclusionThe results suggest that in hypertensive patients with COVID-19, older age, male sex, a diagnosis of diabetes mellitus, and renal replacement therapy were risk factors for a severe clinical course. In addition, the use of ARBs and ACEIs before or after COVID-19 infection did not affect a patient’s risk of contracting COVID-19 nor did it contribute to a worse prognosis for the disease. These results highlighted that precautions should be considered for hypertensive patients with those risk factors and do not support discontinuation of ARBs and ACEIs during COVID-19 pandemic.
Highlights
While hypertension is the most common comorbid condition in patients with coronavirus disease 2019 (COVID-19) in Korea, there is a lack of studies investigating risk factors in COVID-19 patients with hypertension in Korea
The debate centers around the effect of renin-angiotensin system (RAS) modulators such as angiotensinconverting enzyme (ACE) inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infectivity
One school of thought is that these renin-angiotensin system (RAS) modulators increase the risk of developing severe COVID-19, since angiotensin-converting enzyme 2 (ACE2) facilitates the entry of SARS-CoV-2 into the cell [6]
Summary
While hypertension is the most common comorbid condition in patients with coronavirus disease 2019 (COVID-19) in Korea, there is a lack of studies investigating risk factors in COVID-19 patients with hypertension in Korea. We aimed to examine the effects risk factors in hypertensive Korean COVID-19 patients. The debate centers around the effect of RAS modulators such as ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infectivity. One school of thought is that these renin-angiotensin system (RAS) modulators increase the risk of developing severe COVID-19, since ACE2 facilitates the entry of SARS-CoV-2 into the cell [6]. Another school of thought is that these RAS modulators improve the clinical outcome of COVID-19 by regulating the immune function and attenuating the inflammatory response [7]
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