Clinical features of hypertensive patients with COVID-19 compared with a normotensive group: Single-center experience in China

Abstract

Background SARS-CoV-2 has spread worldwide and poses a great threat to human health. Among COVID-19 patients, those with hypertension have been reported to have higher morbidity and mortality. This study was conducted to provide the international community with a deeper understanding of COVID-19 with hypertension. Methods A total of 623 COVID-19 patients enrolled in Wuhan’s hospital were studied from January to March 2020. The epidemiology, clinical features, and laboratory data of hypertensive patients with COVID-19 were collected, retrospectively analyzed, and compared with a normotensive group. The use of antihypertensive drugs, general treatment, and clinical outcomes of hypertensive patients were also analyzed. Results The median ages in hypertensive patients with mild and severe COVID-19 were both significantly greater than the median age in the normotensive group. But there was no significant gender difference between the hypertensive and normotensive groups. All patients had lived in Wuhan area. Common symptoms of all patients included fever, cough, and fatigue. Chest computed tomography (CT) scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. All (315 (100%)) of the hypertensive patients received antiviral therapy (Umifenovir was used alone or in combination with Ribavirin), antibiotic therapy (215 (68.3%)), and corticosteroids (118 (37.5%)). The results suggest that the combination of Umifenovir and Ribavirin as initial therapy for hypertensive patients with COVID-19 is effective and safe. There were no significant differences in laboratory data between the mild cases in the hypertensive and the normotensive groups. In the severe cases, the hypertensive patients had higher plasma levels of D-dimer, C-reactive protein (CRP), and Interleukin-6 (IL-6) (P < 0.05). Furthermore, the hypertensive patients who were treated with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) were not represented in a statistically significant manner between the mild and severe groups (p > 0.05). Conclusion In this study, we demonstrated that the hypertensive patients who were treated with ACEI/ARB did not have an increased risk of developing severe COVID-19. Umifenovir and Ribavirin played an important role in the treatment of viral pneumonia. Hypertensive patients with severe viral pneumonia had stronger inflammatory responses than nonhypertensive patients.

Analysis of Drug Accuracy, Dosage and Drug Interactions in Comorbid Hypertension COVID-19 Patients at Hospital X in Central Java Period 2021

“…These results are in line with Wang et al study regarding the clinical features of comorbid hypertensive COVID-19 patients compared to the non-hypertensive group, which obtained a larger sample of the female sex, namely 56.1% of hypertensive patients and 52.6% of non-hypertensive patients. (10). Based on the accompanying comorbidities hypertension, the 2018 Riskesdas results also show the prevalence rate of hypertension in residents > 18 years according to characteristics in women 36.9% higher than in men (31.3% (11).…”

Arterial Hypertension and Diabetes Mellitus in COVID-19 Patients: What Is Known by Gender Differences?

“…It has been described that hypertension is associated with higher plasma interleukin-6 concentration in COVID-19 patients [25,26]. Levels of IL-6 and other cytokines are not only prominent in patients with severe COVID-19 disease [27,28] but could have profound CV consequences in patients with COVID-19 [29,30]. Mortality rate may increase by 10.5% for patients with CV risk factors, 7.3% for those with diabetes, and 6% for subjects with hypertension [31].…”

Hereditary Angioedema: Diagnosis, Clinical Implications, and Pathophysiology

“…A 2019 study by Mugisho OO, Robilliard LD, Nicholson LFB, Graham ES, O'Carroll SJ., demonstrated increased vascular permeability in human cerebral microvascular endothelial cells with activation of bradykinin 1 receptor; a similar mechanism has been suggested for transient cerebral edema, which is closely associated with hypertension and epileptic seizures. [40][41][42][43][44]. While a specific trigger may cause a severe disease response in one patient, that same trigger may only result in a minor disease response in another patient.…”