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J Clin Med . Association of Hypertension with All-Cause Mortality among Hospitalized Patients with COVID-19

tetano

Editor, Senior Moderator
J Clin Med


. 2020 Sep 28;9(10):E3136.
doi: 10.3390/jcm9103136.
Association of Hypertension with All-Cause Mortality among Hospitalized Patients with COVID-19


Enrique Rodilla[SUP] 1 [/SUP], Alberto Saura[SUP] 1 [/SUP], Iratxe Jim?nez[SUP] 1 [/SUP], Andrea Mendiz?bal[SUP] 1 [/SUP], Araceli Pineda-Cantero[SUP] 2 [/SUP], Elizabeth Lorenzo-Hern?ndez[SUP] 2 [/SUP], Maria Del Pilar Fidalgo-Montero[SUP] 3 [/SUP], Joaqu?n Fernandez L?pez-Cuervo[SUP] 4 [/SUP], Ricardo Gil-S?nchez[SUP] 5 [/SUP], Elisa Rabad?n-Pejenaute[SUP] 6 [/SUP], Lucy Abella-V?zquez[SUP] 7 [/SUP], Vicente Giner-Galva?[SUP] 8 [/SUP], Marta Nataya Sol?s-Marqu?nez[SUP] 9 [/SUP], Ramon Boixeda[SUP] 10 [/SUP], Andr?s de la Pe?a-Fern?ndez[SUP] 11 [/SUP], Francisco Javier Carrasco-S?nchez[SUP] 12 [/SUP], Julio Gonz?lez-Moraleja[SUP] 13 [/SUP], Jos? David Torres-Pe?a[SUP] 14 [/SUP], Mar?a Esther Guisado-Espartero[SUP] 15 [/SUP], Joaqu?n Escobar-Sevilla[SUP] 16 [/SUP], Marcos Guzm?n-Garc?a[SUP] 17 [/SUP], Mar?a Dolores Mart?n-Escalante[SUP] 18 [/SUP], ?ngel Luis Mart?nez-Gonz?lez[SUP] 19 [/SUP], Jos? Manuel Casas-Rojo[SUP] 20 [/SUP], Ricardo G?mez-Huelgas[SUP] 2 [/SUP]



Affiliations

Abstract

It is unclear to which extent the higher mortality associated with hypertension in the coronavirus disease (COVID-19) is due to its increased prevalence among older patients or to specific mechanisms. Cross-sectional, observational, retrospective multicenter study, analyzing 12226 patients who required hospital admission in 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics of survivors versus non-survivors. The mean age of the study population was 67.5 ? 16.1 years, 42.6% were women. Overall, 2630 (21.5%) subjects died. The most common comorbidity was hypertension (50.9%) followed by diabetes (19.1%), and atrial fibrillation (11.2%). Multivariate analysis showed that after adjusting for gender (males, OR: 1.5, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, p = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 0.035). The preexisting condition of hypertension had an independent prognostic value for all-cause mortality in patients with COVID-19 who required hospitalization. ARBs showed a lower risk of lethality in hypertensive patients than other antihypertensive drugs.

Keywords: COVID-19; all-cause mortality; angiotensin II receptor blockers (ARBs); angiotensin-converting enzyme inhibitors (ACEIs); hypertension.
 
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