EFFECT OF HYPERTENSION AND RAS INHIBITORS TO ADULT PATIENTS (OVER 18 YEARS OLD) WITH SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV2) INFECTION WHO WERE ADMITTED TO HOSPITAL

ABSTRACT

Objective: A meta-analysis published in March 2021 concluded that neither the ACE inhibitor nor ARB treatment came together with a higher COVID-19 mortality rate. Our aim was to assess the prevalence of treated HT, the number of antihypertensives and ACE-inhibitors or ARBs of them among Covid-positive patients older than 18 years admitted to the Center for Disease Control 1 of Department of Medicine of the University of Szeged. Design and method: Data of 165 randomly selected patients (mean age 59.9 ± 12.9 yrs., mean BMI 30.7 + 6.6 kg/m2.) were analysed retrospectively. They were admitted between middle of February and end of April 2021. Results: At the time of admission there were 103 (62.4% of all) HT patients (56 men, 47 women). The mean duration of HT was 12.9 ± 6.1 years. The mean number of antihypertensive drugs were 1.6 ± 1.6 pieces (max. 6) at the time of admission. At home 23 patients took more than 3 antihypertensives and 25 patients took exactly 3 drugs. At home 20 patients had monotherapy. The antihypertensive therapy did not change in 74 cases, decreased in 6 cases and increased in 31 cases. In one case we could reduce therapy with 100%, monotherapy was finished, in the other 5 cases it was reduced by 50%. HT patients spent more days in hospital than non-HT patients (10.9 ± 6.8 vs. 9.2 ± 6.3). Spontaneous oxygen saturation (SatO2) was lower in HT patients compared to non-HTs at admission (89.6 ± 9.7% vs. 92.6 ± 4.8) and patients who were on ARBs had the lowest SatO2 (87.5 ± 8.5%, p = 0.01 vs. non-HT). The total mortality rate was 8.7 % in HT patients and it was just 1.6% in non-HT patients. 16.3% of HT patients with RAS-inhibitors and 13.0% without it required admission to the intensive care unit. The mortality rate was 10 % of patients with RAS-inhibitors and 4.3 % of them without it. The mortality rate was 10% of patients with RAS-inhibitors and 4.3% without it. This rate was 13% in patients with ARB and 8.8% with ACE-inhibitor. Conclusions: According to our results, HT may have higher risk for Covid outcomes, including RAS-inhibitors also have a higher risk.