Chen R, 2020, China15
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Investigate the association between in-hospital blood pressure control and covid-19-related outcomes, and compare the effects of different antihypertensive treatments. |
Retrospective cohort study. n = 2,828, 51.0% male, and mean age 60.0 years. |
Elevated cardiomyocyte damage biomarkers in grade 2 and grade 3 groups (p < 0.001). Subjects grade 3 group higher B-type natriuretic peptide and worse cardiac function (p < 0.001). Survival rate of adverse clinical outcomes significantly higher in subjects previously treated with renin-angiotensin-aldosterone system inhibitors (HR: 0.35, 95%CI: 0.13–0.97, p = 0.043) or after (HR 0.18, 95%CI: 0.04–0.86, p = 0.031) admission than treated with other antihypertensive medications. |
Rodilla E, 2020, Spain32
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Analyze whether hypertension represents an independent risk factor for death as a difficult outcome in hospitalized subjects with SARS-CoV-2 in Spain. |
Cross-sectional, observational, multicenter retrospective study. n = 12,226, mean age 67.5, and 42.6% female. |
After adjustment for sex, age tertiles, and Charlson Comorbidity Index scores, hypertension was significantly predictive of all-cause mortality when treated with angiotensin-converting enzyme inhibitors (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (OR: 1.2, p = 0.035). |
Huang S. 2020, China21
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Explore the effect of hypertension on disease progression and prognosis in subjects with coronavirus 2019 disease (covid-19). |
Multicenter retrospective observational study. n = 310, 56.1% male, and mean age 62 years. |
Comparison hypertensive and non-hypertensive subjects with covid-19 without other comorbidities: hypertension showed no significant correlation with length of stay (p = 0.409) or mortality (p = 0.189) of covid-19 disease, hypertensive subjects higher proportion of severe cases (p < 0.001), higher proportion of intensive care unit admission (p = 0.045). Comparison of laboratory indices between hypertensive subjects with covid-19 with and without other comorbidities, most laboratory indices were not significantly different. |
Okay G, 2020, Turkey22
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Investigate the effect of hypertension on clinical severity and prognosis of Coronavirus subjects with covid-19. |
Retrospective observational study. n = 260, 55.4% male and mean age 54.1 ± 15.5 years. |
Subjects with severe and critical clinic higher in the hypertensive than in the non-hypertensive group (p < 0.001). Greater use of oxygen therapy in hypertensive than in non-hypertensive subjects (p = 0.001). Higher rate of admission to intensive care unit in hypertensive subjects than in the non-hypertensive group (p = 0.01). Median values of neutrophil count, aspartate aminotransferase, lactate dehydrogenase and creatinine higher in hypertensive subjects than in non-hypertensive subjects. (p = 0.001; p = 0.016; p = 0.002; p < 0.001, respectively). Median albumin values and glomerular filtration rate lower in hypertensive subjects (p = 0.002 and p < 0.001, respectively). |
Ghao G, 2020, China29
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Investigate whether treatment of hypertension, primarily with renin-angiotensin-aldosterone system (RASA) inhibitors, can impact mortality in subjects with covid-19. |
Retrospective observational study. n = 2,877, hypertensives n = 850 (83.5% taking antihypertensive medications). |
Hypertensive subjects without antihypertensive treatment: higher mortality rate compared to those with antihypertensive treatments (7.9% vs. 3.2%, HR: 2.52, 95%CI: 1.23–5.17, p = 0.012). After adjustment, even higher mortality risk in subjects without antihypertensive treatment (HR: 2.17, 95%CI: 1.03– 4.57,= 0.041). The numerical difference in mortality rates between the renin-angiotensin-aldosterone system inhibitor and non-inhibitor cohorts were not significant before or after adjustment (2.2% vs. 3.6%, adjusted HR: 0.85, 95%CI: 0.28–2.58, p = 0.774). |
Yao Q, 2020, China24
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Explore the characteristics and differences in outcomes between hypertensive and non-hypertensive subjects with covid-19. |
Observational retrospective study. n = 414, median age 61 years 50.1% male, and 36.0% hypertensive participants. |
Compared with normotensives, hypertensive participants had a higher risk of death (HR: 2.68, 95%CI:1.46– 4.91), after adjustment for age and sex, no difference was shown (HR:1.77, 95%CI: 0.93–3.36). Hypertensive subjects had more complications: shock (p = 0.009), acute respiratory distress syndrome (p = 0.003), acute kidney injury (p = 0.001), greater use of non-invasive mechanical ventilation (p = 0.026), and invasive mechanical ventilation IMV (p = 0.020). Lab results on admission: hypertensive subjects had higher levels of hemoglobin (p = 0.049), D-dimer (p = 0.007), blood urea nitrogen (p = 0.000) and serum creatinine (p = 0.000). |
Xiong TY, 2020, China25
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Characterize the prevalence and clinical implications of comorbidities in subjects with covid-19. |
Retrospective multicenter study. n = 472 53.0% male, median age 43 years, hypertensive subjects n = 71. |
Comparison hypertensive and non-hypertensive subjects: the hypertensive ones more prone to treatments with angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB), β-blockers, calcium channel blocker (CCB) (p < 0, 001) and statins (p = 0.006), greater chance of experiencing the composite outcome (p < 0.001) and individual outcome, including intensive care unit admission (p < 0.001), mechanical ventilation (p < 0.001) and death (p = 0.012). Occurrence of adverse events did not differ between subjects treated with and without antihypertensive drugs. |
Li J, 2020, China30
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Investigate the association between angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), and disease severity and mortality in subjects with hypertension hospitalized for covid-19 infection. |
Retrospective study. n = 1,178, hypertensive subjects n = 362 (52.2% male, 71.5% older than 60 years, and 31.8% were on ACEI / ARBs). |
Analysis in the hypertensive group: similar laboratory profile results, except higher alkaline phosphatase in those not taking angiotensin-converting enzyme inhibitors (ACEI) / angiotensin receptor blockers (ARB) (p < 0.001), frequency of disease severity, acute respiratory distress syndrome and mortality did not differ in relation to ACEI / ARB therapy. With regard to IECA/ARB use, there was no difference between those with severe versus non-severe disease in the use of IECA (p = 0.80), ARBs (p = 0.40), or the composite of IECA / ARBs (p = 0.65). Similarly, there were no differences between non-survivors and survivors in the use of IECA (p = 0.85), ARBs (p = 0.42), or the composite of IECA / ARBs (p = 0.34). |
Zhou X, 2020, China27
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Explore the clinical features of covid-19 complicated by hypertension. |
Single center retrospective study. n = 110, mean age 57.7 years, 54.5% male, hypertensive subjects n = 36 (52.8% male). |
Compared to non-hypertensive subjects, those hypertensive had higher occurrence of dyspnea (p < 0.001), diabetes (p < 0.001) and cardiovascular disease (p = 0.022), lower lymphocyte count on admission (p < 0.01), higher crude mortality rate (p < 0.01). Taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was not significantly associated with prognosis (p = 0.162). |
Chengyi HU, 2020, China26
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Determine the impact of hypertension on outcomes in subjects with covid-19. |
Observational retrospective cohort study. n = 442, hypertensive subjects n = 61. |
Compared to normotensive subjects, those hypertensive were more likely to develop bacterial infections (p = 0.002), higher neutrophil counts (p = 0.007), neutrophil to lymphocyte ratio (p = 0.045) and lactate dehydrogenase (p = 0.035). A higher proportion of subjects had bilateral irregular opacities on chest CT scan (p = 0.012) in the hypertension group than in the normotensive group. Hypertensive subjects were more likely to receive antibiotics (p = 0.035) and corticosteroid therapy (p = 0.035). |
Pan W, 2020, China31
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Clarify the impact of hypertension on covid-19, and investigate whether prior use of renin-angiotensin-aldosterone system (RAAS) inhibitors affects the prognosis of covid-19. |
Single center retrospective study. n = 996, hypertensive subjects n = 282. |
Hypertension unpaired cohort (HR 1.80, 95%CI: 1.20–2.70); paired cohort (HR 2.24, 95%CI: 1.36–3.70) independently associated with all causes of mortality in subjects with covid-19. There were no significant differences in baseline clinical characteristics between subjects with hypertension who used and did not use renin-angiotensin-aldosterone system (RASA) inhibitors. All-cause mortality rate was significantly lower in the SRAA inhibitor treatment group than in the no-SRAA inhibitor treatment group (p = 0.037). |
Trump S, 2020, Germany23
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Evaluate the effect of coexisting cardiovascular disease, in particular hypertension and antihypertensive treatment, on covid-19 pathology and viral clearance. |
Prospective observational cohort study. n = 144, 67.4% male. Hypertensive subjects with or without cardiovascular disease n = 90, and subjects without hypertension and without cardiovascular disease n = 54. |
Higher risk of developing critical covid-19 for hypertensive subjects with/without coexisting cardiovascular disease compared to non-hypertensive subjects (adjusted odds ratio (adjOR) = 4.28, 95%CI: confidence interval: 1.60–11.46, p = 0.028). Patients treated with angiotensin receptor blockers (ARB) increased risk of critical covid-19 compared with non-hypertensive subjects (adjOR = 4.14, 95%CI: 1.01–17.04, p = 0.044). Risk of critical disease lower than for hypertensive subjects without treatment with angiotensin-converting enzyme inhibitors (ACEIs) or ARBs (adjOR = 8.17, 95%CI: 1.65–40.52, p = 0.009). No difference in ACE2 expression and initial viral concentration between subject groups. |
Yang Q, 2020, China28
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Explore the impact of hypertension on outcomes in subjects with covid-19. |
Retrospective cohort study. n = 226, hypertensive subjects n = 84. |
Subjects divided into survivor and non-survivor groups. Ratio of hypertensive subjects among non-survivors was higher than among survivors (26.70% vs. 74.00%; p < 0.001). Hypertensive subjects had higher risk of death (HR: 2.679, 95%CI: 1.237–5.805; p = 0.012), elevated D-dimer levels (HR: 1.025, 95%CI: 1.011–1.039; p < 0.001) and higher neutrophil to lymphocyte ratio (HR: 1.107, 95%CI: 1.053–1.164; p < 0.001). |