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Clinical Features of COVID-19 in Patients With Essential Hypertension and the Impacts of Renin-angiotensin-aldosterone System Inhibitors on the Prognosis of COVID-19 Patients.
Pan, Wei; Zhang, Jishou; Wang, Menglong; Ye, Jing; Xu, Yao; Shen, Bo; He, Hua; Wang, Zhen; Ye, Di; Zhao, Mengmeng; Luo, Zhen; Liu, Mingxiao; Zhang, Pingan; Gu, Jian; Liu, Menglin; Li, Dan; Liu, Jianfang; Wan, Jun.
  • Pan W; From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.
  • Zhang J; Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • Wang M; Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • Ye J; From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.
  • Xu Y; Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • Shen B; Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • He H; From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.
  • Wang Z; Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • Ye D; Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • Zhao M; From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.
  • Luo Z; Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • Liu M; Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • Zhang P; From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.
  • Gu J; Cardiovascular Research Institute, Wuhan University, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • Liu M; Hubei Key Laboratory of Cardiology, Wuhan, China (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.).
  • Li D; Department of Medical Affairs (B.S., H.H.), Renmin Hospital of Wuhan University, China.
  • Liu J; Department of Medical Affairs (B.S., H.H.), Renmin Hospital of Wuhan University, China.
  • Wan J; From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.
Hypertension ; 76(3): 732-741, 2020 09.
Article in English | MEDLINE | ID: covidwho-641910
ABSTRACT
Hypertension is one of the most common comorbidities in patients with coronavirus disease 2019 (COVID-19). This study aimed to clarify the impact of hypertension on COVID-19 and investigate whether the prior use of renin-angiotensin-aldosterone system (RAAS) inhibitors affects the prognosis of COVID-19. A total of 996 patients with COVID-19 were enrolled, including 282 patients with hypertension and 714 patients without hypertension. Propensity score-matched analysis (11 matching) was used to adjust the imbalanced baseline variables between the 2 groups. Patients with hypertension were further divided into the RAAS inhibitor group (n=41) and non-RAAS inhibitor group (n=241) according to their medication history. The results showed that COVID-19 patients with hypertension had more severe secondary infections, cardiac and renal dysfunction, and depletion of CD8+ cells on admission. Patients with hypertension were more likely to have comorbidities and complications and were more likely to be classified as critically ill than those without hypertension. Cox regression analysis revealed that hypertension (hazard ratio, 95% CI, unmatched cohort [1.80, 1.20-2.70]; matched cohort [2.24, 1.36-3.70]) was independently associated with all-cause mortality in patients with COVID-19. In addition, hypertensive patients with a history of RAAS inhibitor treatment had lower levels of C-reactive protein and higher levels of CD4+ cells. The mortality of patients in the RAAS inhibitor group (9.8% versus 26.1%) was significantly lower than that of patients in the non-RAAS inhibitor group. In conclusion, hypertension may be an independent risk factor for all-cause mortality in patients with COVID-19. Patients who previously used RAAS inhibitors may have a better prognosis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Pandemics / Essential Hypertension Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Hypertension Year: 2020 Document Type: Article Affiliation country: HYPERTENSIONAHA.120.15289

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Pandemics / Essential Hypertension Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Hypertension Year: 2020 Document Type: Article Affiliation country: HYPERTENSIONAHA.120.15289