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Hypertension and COVID-19: Relation with Complications, Comorbidities and Mortality

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Resumo:Introduction: SARS-CoV-2 infection is characterized by hyperproduction of pro-inflammatory cytokines that impact the cardiovascular system. In addition, several cardiovascular risk factors, like arterial hypertension, were identified as risk factors for greater disease severity and mortality in these patients. The objective of this study is to evaluate the prevalence of hypertension in patients with COVID-19 and its association with complications, comorbidities and mortality. Methods: Retrospective study of the patients with COVID-19 admitted to Internal Medicine ward between March 2020 and February 2021. Data was collected from the digital clinical file. Logistic regression was applied to clarify the effect of independent variables on mortality. Results: The sample included 1291 patients with COVID-19, a median age of 73 years (IQR: 22) and male gender predominance (n = 701, 54.3%). There were 65.5% (n = 845) of patients with hypertension, 54.9% (n = 709) dyslipidemia and about a third had diabetes mellitus and obesity (31 and 38%, respectively). Comparatively to the non-hypertensive patients, hypertensive group presented with higher prevalence of other cardiovascular risk factors (diabetes mellitus, obesity and dyslipidemia (p <0.001)) and lower functionality and more comorbidities (as calculated by AVDezIS and Charlson modified scores, p<0.001). There was also higher proportion of severe COVID-19 disease (p = 0.003), greater number of patients admitted to intensive care units (p <0.001) and higher in-hospital mortality (p <0.001). Hypertension was not a mortality predictive factor in these patients. Conclusion: In this study, patients with hypertension presented with higher severity of COVID-19 disease, higher prevalence of other cardiovascular risk factors, complications during hospitalization and in-hospital mortality, however, its presence was not a mortality predictive factor.
Autores principais:Gonçalves Fontoura, Mário Gil
Outros Autores:Campos Cunha, João; Dias, Diana; Machado, Filipe; Soares, Bruno; Ribeiro, Heloísa
Assunto:Comorbilidade COVID-19 Hipertensão Mortalidade Hospitalar SARS-CoV-2 Comorbidity COVID-19 Hospital Mortality Hypertension SARS-CoV-2
Ano:2023
País:Portugal
Tipo de documento:artigo
Tipo de acesso:unknown
Instituição associada:Sociedade Portuguesa de Medicina Interna
Idioma:português
Origem:Revista Portuguesa de Medicina Interna
Descrição
Resumo:Introduction: SARS-CoV-2 infection is characterized by hyperproduction of pro-inflammatory cytokines that impact the cardiovascular system. In addition, several cardiovascular risk factors, like arterial hypertension, were identified as risk factors for greater disease severity and mortality in these patients. The objective of this study is to evaluate the prevalence of hypertension in patients with COVID-19 and its association with complications, comorbidities and mortality. Methods: Retrospective study of the patients with COVID-19 admitted to Internal Medicine ward between March 2020 and February 2021. Data was collected from the digital clinical file. Logistic regression was applied to clarify the effect of independent variables on mortality. Results: The sample included 1291 patients with COVID-19, a median age of 73 years (IQR: 22) and male gender predominance (n = 701, 54.3%). There were 65.5% (n = 845) of patients with hypertension, 54.9% (n = 709) dyslipidemia and about a third had diabetes mellitus and obesity (31 and 38%, respectively). Comparatively to the non-hypertensive patients, hypertensive group presented with higher prevalence of other cardiovascular risk factors (diabetes mellitus, obesity and dyslipidemia (p <0.001)) and lower functionality and more comorbidities (as calculated by AVDezIS and Charlson modified scores, p<0.001). There was also higher proportion of severe COVID-19 disease (p = 0.003), greater number of patients admitted to intensive care units (p <0.001) and higher in-hospital mortality (p <0.001). Hypertension was not a mortality predictive factor in these patients. Conclusion: In this study, patients with hypertension presented with higher severity of COVID-19 disease, higher prevalence of other cardiovascular risk factors, complications during hospitalization and in-hospital mortality, however, its presence was not a mortality predictive factor.

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