Association of hypertension with the severity and fatality of SARS-CoV-2 infection: A meta-analysis

Zhang, Jingqi; Wu, Jing; Sun, Xin; Xue, Hong; Shao, Jianghua; Cai, Wei; Yang, Jing; Yue, Ming; Dong, Chen

doi:10.1017/s095026882000117x

Cited by 89 publications

(89 citation statements)

References 33 publications

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“…This enzyme is widely expressed in different organs which may make them susceptible to this virus. Due to some documents using ACE-Inhibitors and Angiotensin receptor blockers (ARBs) can increase the expression of ACE-2 which may increase the field of binding virus and makes the host susceptible (14). Based on these, in fact, ACE-2 acts by catalyzing AngII to Ang1-7 and increases its anti-inflammatory effect (15).…”

Section: Resultsmentioning

confidence: 99%

Survival rate in hypertensive patients with COVID-19

Emami

Javanmardi

Akbari

et al. 2020

Clinical and Experimental Hypertension

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Introduction: A life-threatening respiratory disease, coronavirus 2019 (COVID-19), has spread across the globe since December 2019. Many prognostic factors have already been put forward to predict the risk of death and other outcomes. The current study is evaluating the survival rate between hypertensive and non-hypertensive infected patients. Methods: Patients who were included in this study were admitted between 20 February to 1 March 2020 in Fars (southwest of Iran) province hospitals. Data were collected from the electronic base registry which contained demographic information, medical symptoms, and signs, underlying diseases, CT scan results, and final outcome. Results: Of all 1239 positive cases, 159 (12.83%) had known with hypertension ant this group was significantly older than non-hypertensive patients (66.1 years Vs 48.95 years, p < .001). According to Kaplan-Meier survival curve and log-rank test, it was seen hypertensive patients deteriorated more rapidly than non-hypertensive group (p = .032). Moreover, HIV, cardiovascular, and kidney disease were diagnosed as factors that increase the risk of death in hypertensive patients. Conclusion: The current study about the survival rate of COVID-19 patients had shown hypertensive patents are in danger of disease severity, although it may be related to their age. Moreover, the probability of other complications like diabetes, smoking, asthma, kidney, and cardiovascular diseases, and either some other infections such as HIV can make the condition complicated and need more consideration to prevent noxious outcomes.

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Section: Resultsmentioning

confidence: 99%

Survival rate in hypertensive patients with COVID-19

Emami

Javanmardi

Akbari

et al. 2020

Clinical and Experimental Hypertension

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“…In this study, 85.7% of the severe patients had comorbidities. This may be due to abnormal immune function and increased susceptibility to SARS-CoV-2 in patients with comorbidities [26,27]. In addition, COVID-19 damage to the lungs can aggravate some comorbidities, such as chronic obstructive pulmonary disease.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of 276 hospitalized patients with coronavirus disease 2019 in Zengdu District, Hubei Province: a single-center descriptive study

et al. 2020

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Background: We aimed to report the epidemiological and clinical characteristics of hospitalized patients with coronavirus disease-19 (COVID-19) in Zengdu District, Hubei Province, China. Methods: Clinical data on COVID-19 inpatients in Zengdu Hospital from January 27 to March 11, 2020 were collected; this is a community hospital in an area surrounding Wuhan and supported by volunteer doctors. All hospitalized patients with COVID-19 were included in this study. The epidemiological findings, clinical features, laboratory findings, radiologic manifestations, and clinical outcomes of these patients were analyzed. The patients were followed up for clinical outcomes until March 22, 2020. Severe COVID-19 cases include severe and critical cases diagnosed according to the seventh edition of China's COVID-19 diagnostic guidelines. Severe and critical COVID-19 cases were diagnosed according to the seventh edition of China's COVID-19 diagnostic guidelines. Results: All hospitalized COVID-19 patients, 276 (median age: 51.0 years), were enrolled, including 262 non-severe and 14 severe patients. The proportion of patients aged over 60 years was higher in the severe group (78.6%) than in the non-severe group (18.7%, p < 0.01). Approximately a quarter of the patients (24.6%) had at least one comorbidity, such as hypertension, diabetes, or cancer, and the proportion of patients with comorbidities was higher in the severe group (85.7%) than in the non-severe group (21.4%, p < 0.01). Common symptoms included fever (82.2% [227/276]) and cough (78.0% [218/276]). 38.4% (106/276) of the patients had a fever at the time of admission. Most patients (94.9% [204/276]) were cured and discharged; 3.6% (10/276) deteriorated to a critical condition and were transferred to another hospital. The median COVID-19 treatment duration and hospital stay were 14.0 and 18.0 days, respectively.

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“…To the best of our knowledge, no meta-analysis specifically designed to assess the role of age, sex and health condition of the studied populations with a comprehensive list of potential clinical predictors of mortality in hospitalized patients with confirmed COVID-19 has been reported. Thus far, Zhang et al [ 11 ] observed that the association between hypertension and mortality was stronger in studies with patients who are less than 50 years old (OR = 6.4) than in those 50 years old and older (OR = 2.6), although the authors included only six studies in their meta-analysis. In another study, Pranata et al [ 12 ] used meta-regression methods and found an association between hypertension and increased composite worse outcome, including mortality, which is influenced by sex (more strongly when the population is less than 55% male patients), but not age.…”

Section: Introductionmentioning

confidence: 99%

Predictors of in-hospital COVID-19 mortality: A comprehensive systematic review and meta-analysis exploring differences by age, sex and health conditions

et al. 2020

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Objective Risk factors for in-hospital mortality in confirmed COVID-19 patients have been summarized in numerous meta-analyses, but it is still unclear whether they vary according to the age, sex and health conditions of the studied populations. This study explored these variables as potential mortality predictors. Methods A systematic review was conducted by searching the MEDLINE, Scopus, and Web of Science databases of studies available through July 27, 2020. The pooled risk was estimated with the odds ratio (p-OR) or effect size (p-ES) obtained through random-effects meta-analyses. Subgroup analyses and meta-regression were applied to explore differences by age, sex and health conditions. The MOOSE guidelines were strictly followed. Results The meta-analysis included 60 studies, with a total of 51,225 patients (12,458 [24.3%] deaths) from hospitals in 13 countries. A higher in-hospital mortality risk was found for dyspnoea (p-OR = 2.5), smoking (p-OR = 1.6) and several comorbidities (p-OR range: 1.8 to 4.7) and laboratory parameters (p-ES range: 0.3 to -2.6). Age was the main source of heterogeneity, followed by sex and health condition. The following predictors were more markedly associated with mortality in studies with patients with a mean age ≤60 years: dyspnoea (p-OR = 4.3), smoking (p-OR = 2.8), kidney disease (p-OR = 3.8), hypertension (p-OR = 3.7), malignancy (p-OR = 3.7), diabetes (p-OR = 3.2), pulmonary disease (p-OR = 3.1), decreased platelet count (p-ES = -1.7), decreased haemoglobin concentration (p-ES = -0.6), increased creatinine (p-ES = 2.4), increased interleukin-6 (p-ES = 2.4) and increased cardiac troponin I (p-ES = 0.7). On the other hand, in addition to comorbidities, the most important mortality predictors in studies with older patients were albumin (p-ES = -3.1), total bilirubin (p-ES = 0.7), AST (p-ES = 1.8), ALT (p-ES = 0.4), urea nitrogen (p-ES), C-reactive protein (p-ES = 2.7), LDH (p-ES = 2.4) and ferritin (p-ES = 1.7). Obesity was associated with increased mortality only in studies with fewer chronic or critical patients (p-OR = 1.8). Conclusion The prognostic effect of clinical conditions on COVID-19 mortality vary substantially according to the mean age of patients. PROSPERO registration number CRD42020176595.

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Association of hypertension with the severity and fatality of SARS-CoV-2 infection: A meta-analysis

Cited by 89 publications

References 33 publications

Survival rate in hypertensive patients with COVID-19

Survival rate in hypertensive patients with COVID-19

Clinical characteristics of 276 hospitalized patients with coronavirus disease 2019 in Zengdu District, Hubei Province: a single-center descriptive study

Predictors of in-hospital COVID-19 mortality: A comprehensive systematic review and meta-analysis exploring differences by age, sex and health conditions

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