1. COVID-19 and the impact of arterial hypertension-An analysis of the international HOPE COVID-19 Registry (Italy-Spain-Germany).
- Author
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El-Battrawy I, Nuñez-Gil IJ, Abumayyaleh M, Estrada V, Manuel Becerra-Muñoz V, Uribarri A, Fernández-Rozas I, Feltes G, Arroyo-Espliguero R, Trabattoni D, López-País J, Pepe M, Romero R, Castro-Mejía AF, Cerrato E, Capel Astrua T, D'Ascenzo F, Fabregat-Andres O, Signes-Costa J, Marín F, Buonsenso D, Bardají A, Jesús Tellez M, Fernández-Ortiz A, Macaya C, and Akin I
- Subjects
- Age Factors, Aged, Angiotensin Receptor Antagonists therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Antiviral Agents therapeutic use, COVID-19 metabolism, COVID-19 therapy, Creatinine metabolism, Female, Germany epidemiology, Hospital Mortality, Humans, Hypertension drug therapy, Italy epidemiology, L-Lactate Dehydrogenase metabolism, Male, Middle Aged, Multivariate Analysis, Noninvasive Ventilation, Proportional Hazards Models, Registries, Respiration, Artificial, SARS-CoV-2, Severity of Illness Index, Spain epidemiology, Acute Kidney Injury epidemiology, COVID-19 epidemiology, Heart Failure epidemiology, Hypertension epidemiology, Pneumonia epidemiology, Respiratory Insufficiency epidemiology, Sepsis epidemiology
- Abstract
Background: A systematic analysis of concomitant arterial hypertension in COVID-19 patients and the impact of angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARBs) have not been studied in a large multicentre cohort yet. We conducted a subanalysis from the international HOPE Registry (https://hopeprojectmd.com, NCT04334291) comparing COVID-19 in presence and absence of arterial hypertension., Materials and Methods: Out of 5837 COVID-19 patients, 2850 (48.8%) patients had the diagnosis arterial hypertension. 1978/2813 (70.3%) patients were already treated with ACEI or ARBs. The clinical outcome of the present subanalysis included all-cause mortality over 40 days of follow-up., Results: Patients with arterial hypertension suffered significantly more from different complications including respiratory insufficiency (60.8% vs 39.5%), heart failure (9.9% vs 3.1%), acute kidney injury (25.3% vs 7.3%), pneumonia (90.6% vs 86%), sepsis (14.7% vs 7.5%), and bleeding events (3.6% vs 1.6%). The mortality rate was 29.6% in patients with concomitant arterial hypertension and 11.3% without arterial hypertension (P < .001). Invasive and non-invasive respiratory supports were significantly more required in presence of arterial hypertension as compared without it. In the multivariate cox regression analysis, while age≥65, benzodiazepine, antidepressant at admission, elevated LDH or creatinine, respiratory insufficiency and sepsis might be a positive independent predictors of mortality, antiviral drugs, interferon treatment, ACEI or ARBs at discharge or oral anticoagulation at discharge might be an independent negative predictor of the mortality., Conclusions: The mortality rate and in-hospital complications might be increased in COVID-19 patients with a concomitant history of arterial hypertension. The history of ACEI or ARBs treatments does not seem to impact the outcome of these patients., (© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)
- Published
- 2021
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