The effects of antihypertensive medications on severity and outcomes of hypertensive patients with COVID-19

Abstract

In Covid-19 pandemic, specific comorbidities are associated with the increased risk of worse outcomes and increased severity of lung injury and mortality. the aim of this study was to investigate the effects of antihypertensive medications on the severity and outcomes of hypertensive patients with COVID-19. This retrospective observational study conducted on patients with COVID-19 who referred to Afzalipour Hospital, Kerman, Iran during the six months from 19 February 2020 to 20 July 2020. The data were collected through medical chart reviews. We assessed 265 patients with Covid-19 and they stratified based on hypertension and type of antihypertension medications. The data were described and Student’s t -test, Mann–Whitney U and Fisher exact test were run to compare the patients ‘demographical and clinical information. The qualitative variables were compared using the by SPSS software version 23. The results of the present study showed that hypertension was a prevalent comorbidity among patients with COVID-19 and hypertensive patients compared to other patients without any comorbidity who were older ( P -value: 0.03). The oxygen saturation was higher for the patients in the control group than hypertensive patients ( P -value: 0.01). The severity of COVID-19 and its outcome were not different between the patients who took or did not take antihypertensive medications and also the type of antihypertensive medications. Hypertensive patients did not show any significant difference in survival, hospital stay, ICU admission, disease severity, and invasive medical ventilation in other normotensive patients with COVID-19.

Impact and prevalence of comorbidities and complications on the severity of COVID-19 in association with age, gender, obesity, and pre-existing smoking: A meta-analysis

“…According to our results, most patients with severe COVID-19 were older than those with non-severe COVID-19 and the prevalence of hypertension in our study was 14.29 % with an OR of 2.22 and with an OR of 2.17 for coronary heart disease and arrhythmic complications (OR = 7.47) implicated in the worsening of COVID-19 in patients. These results were consistent with related studies [ 70 , 71 ]. SARS-CoV-2 infection is therefore associated with a high inflammatory load that can induce vascular inflammation, myocarditis, and cardiac arrhythmias.…”

“…In the severe form of COVID-19, there is a strong correlation between hypertension and age, on the one hand, and coronary heart disease on the other hand. This correlation could explain the high prevalence of hypertension in patients with severe COVID-19 [ 70 , 71 ]. Considered the leading reversible risk factor for cardiovascular morbidity and mortality, contributing to the development of vulnerable cardiovascular areas and acute myocardial affections favoring severe and fatal forms of COVID-19 [ 72 ].…”

“…Considered the leading reversible risk factor for cardiovascular morbidity and mortality, contributing to the development of vulnerable cardiovascular areas and acute myocardial affections favoring severe and fatal forms of COVID-19 [ 72 ]. Recent reports have shown that the prevalence of hypertension in patients with COVID-19 is considerable, ranging from 9.6 % to 40.8 % [ 70 ]. According to our results, most patients with severe COVID-19 were older than those with non-severe COVID-19 and the prevalence of hypertension in our study was 14.29 % with an OR of 2.22 and with an OR of 2.17 for coronary heart disease and arrhythmic complications (OR = 7.47) implicated in the worsening of COVID-19 in patients.…”

“…However, in patients with severe coronavirus disease, angiotensin-1 is converted to angiotensin-2 by ACE, leading to inflammation, oxidative stress, fibrosis, vasoconstriction and increased vascular permeability contributing to ARDS [ 71 ]. In addition, it has been reported that some antihypertensive drugs can affect hemoglobin levels in hypertensive patients with diabetes mellitus, which could be associated with the severity of COVID-19 [ 70 ]. In general, comorbidities such as hypertension, diabetes, obesity, and smoking are strongly associated with vascular endothelial damage, dysfunction of the hemostatic system, and chronic inflammation.…”

The Associations of Antihypertensive Medications, Steroids, Beta Blockers, Statins and Comorbidities with COVID-19 Outcomes in Patients with and without Chronic Kidney Disease: A Retrospective Study

“…However, a randomized clinical trial investigating the outcomes of COVID-19 patients with hypertension and without CKD who took losartan (an ARB) versus amlodipine (CCB) showed no difference between the two in morbidity and mortality [9]. Two additional studies found that the use of ACEi and ARB in hypertensive patients with COVID-19 did not alter the survival or severity of the disease compared to normotensive patients [10,11]. One study investigating the use of CCBs in COVID-19 patients found that CCB use in hypertensive patients with COVID-19 reduced mortality rates [12].…”