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Clinical Features of COVID-19 in Patients With Essential Hypertension and the Impacts of Renin-angiotensin-aldosterone System Inhibitors on the Prognosis of COVID-19 Patients.
- Source :
-
Hypertension (Dallas, Tex. : 1979) [Hypertension] 2020 Sep; Vol. 76 (3), pp. 732-741. Date of Electronic Publication: 2020 Jul 13. - Publication Year :
- 2020
-
Abstract
- Hypertension is one of the most common comorbidities in patients with coronavirus disease 2019 (COVID-19). This study aimed to clarify the impact of hypertension on COVID-19 and investigate whether the prior use of renin-angiotensin-aldosterone system (RAAS) inhibitors affects the prognosis of COVID-19. A total of 996 patients with COVID-19 were enrolled, including 282 patients with hypertension and 714 patients without hypertension. Propensity score-matched analysis (1:1 matching) was used to adjust the imbalanced baseline variables between the 2 groups. Patients with hypertension were further divided into the RAAS inhibitor group (n=41) and non-RAAS inhibitor group (n=241) according to their medication history. The results showed that COVID-19 patients with hypertension had more severe secondary infections, cardiac and renal dysfunction, and depletion of CD8 <superscript>+</superscript> cells on admission. Patients with hypertension were more likely to have comorbidities and complications and were more likely to be classified as critically ill than those without hypertension. Cox regression analysis revealed that hypertension (hazard ratio, 95% CI, unmatched cohort [1.80, 1.20-2.70]; matched cohort [2.24, 1.36-3.70]) was independently associated with all-cause mortality in patients with COVID-19. In addition, hypertensive patients with a history of RAAS inhibitor treatment had lower levels of C-reactive protein and higher levels of CD4 <superscript>+</superscript> cells. The mortality of patients in the RAAS inhibitor group (9.8% versus 26.1%) was significantly lower than that of patients in the non-RAAS inhibitor group. In conclusion, hypertension may be an independent risk factor for all-cause mortality in patients with COVID-19. Patients who previously used RAAS inhibitors may have a better prognosis.
- Subjects :
- Betacoronavirus
COVID-19
China epidemiology
Comorbidity
Female
Hospital Mortality
Humans
Male
Middle Aged
Prognosis
Renin-Angiotensin System drug effects
Retrospective Studies
Risk Assessment
SARS-CoV-2
Angiotensin Receptor Antagonists administration & dosage
Angiotensin Receptor Antagonists adverse effects
Angiotensin-Converting Enzyme Inhibitors administration & dosage
Angiotensin-Converting Enzyme Inhibitors adverse effects
Coronavirus Infections diagnosis
Coronavirus Infections mortality
Coronavirus Infections physiopathology
Essential Hypertension diagnosis
Essential Hypertension drug therapy
Essential Hypertension epidemiology
Pandemics
Pneumonia, Viral diagnosis
Pneumonia, Viral mortality
Pneumonia, Viral physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4563
- Volume :
- 76
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Hypertension (Dallas, Tex. : 1979)
- Publication Type :
- Academic Journal
- Accession number :
- 32654555
- Full Text :
- https://doi.org/10.1161/HYPERTENSIONAHA.120.15289