Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension: a multinational cohort study

Bibliographic Details
Title: Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension: a multinational cohort study
Authors: Diana Puente, Talita Duarte-Salles, Thamir M Alshammari, Sergio Fernández-Bertolín, Michael E Matheny, Carlos Areia, Carlen Reyes, Fredrik Nyberg, Heba Alghoul, Osaid Alser, Christian Reich, Patrick Ryan, Nigam Shah, Lana Lai, Albert Prats-Uribe, Scott L DuVall, Seng Chan You, Anthony G Sena, Dalia Dawoud, Asieh Golozar, Jose D Posada, Martina Recalde, Elena Roel, Lisa M Schilling, Kristine E Lynch, Peter R Rijnbeek, George Hripcsak, Marc A Suchard, Kristin Kostka, Anna Ostropolets, Andrea Pistillo, Clair Blacketer, Waheed-UI-Rahman Ahmed, Neus Valveny, Gabriel de Maeztu, Luisa Sorlí Redó, Jordi Martinez Roldan, Inmaculada Lopez Montesinos
Source: BMJ Open, Vol 11, Iss 12 (2021)
Publisher Information: BMJ Publishing Group, 2021.
Publication Year: 2021
Collection: LCC:Medicine
Subject Terms: Medicine
More Details: Objective To characterise patients with and without prevalent hypertension and COVID-19 and to assess adverse outcomes in both inpatients and outpatients.Design and setting This is a retrospective cohort study using 15 healthcare databases (primary and secondary electronic healthcare records, insurance and national claims data) from the USA, Europe and South Korea, standardised to the Observational Medical Outcomes Partnership common data model. Data were gathered from 1 March to 31 October 2020.Participants Two non-mutually exclusive cohorts were defined: (1) individuals diagnosed with COVID-19 (diagnosed cohort) and (2) individuals hospitalised with COVID-19 (hospitalised cohort), and stratified by hypertension status. Follow-up was from COVID-19 diagnosis/hospitalisation to death, end of the study period or 30 days.Outcomes Demographics, comorbidities and 30-day outcomes (hospitalisation and death for the ‘diagnosed’ cohort and adverse events and death for the ‘hospitalised’ cohort) were reported.Results We identified 2 851 035 diagnosed and 563 708 hospitalised patients with COVID-19. Hypertension was more prevalent in the latter (ranging across databases from 17.4% (95% CI 17.2 to 17.6) to 61.4% (95% CI 61.0 to 61.8) and from 25.6% (95% CI 24.6 to 26.6) to 85.9% (95% CI 85.2 to 86.6)). Patients in both cohorts with hypertension were predominantly >50 years old and female. Patients with hypertension were frequently diagnosed with obesity, heart disease, dyslipidaemia and diabetes. Compared with patients without hypertension, patients with hypertension in the COVID-19 diagnosed cohort had more hospitalisations (ranging from 1.3% (95% CI 0.4 to 2.2) to 41.1% (95% CI 39.5 to 42.7) vs from 1.4% (95% CI 0.9 to 1.9) to 15.9% (95% CI 14.9 to 16.9)) and increased mortality (ranging from 0.3% (95% CI 0.1 to 0.5) to 18.5% (95% CI 15.7 to 21.3) vs from 0.2% (95% CI 0.2 to 0.2) to 11.8% (95% CI 10.8 to 12.8)). Patients in the COVID-19 hospitalised cohort with hypertension were more likely to have acute respiratory distress syndrome (ranging from 0.1% (95% CI 0.0 to 0.2) to 65.6% (95% CI 62.5 to 68.7) vs from 0.1% (95% CI 0.0 to 0.2) to 54.7% (95% CI 50.5 to 58.9)), arrhythmia (ranging from 0.5% (95% CI 0.3 to 0.7) to 45.8% (95% CI 42.6 to 49.0) vs from 0.4% (95% CI 0.3 to 0.5) to 36.8% (95% CI 32.7 to 40.9)) and increased mortality (ranging from 1.8% (95% CI 0.4 to 3.2) to 25.1% (95% CI 23.0 to 27.2) vs from 0.7% (95% CI 0.5 to 0.9) to 10.9% (95% CI 10.4 to 11.4)) than patients without hypertension.Conclusions COVID-19 patients with hypertension were more likely to suffer severe outcomes, hospitalisations and deaths compared with those without hypertension.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2044-6055
Relation: https://bmjopen.bmj.com/content/11/12/e057632.full; https://doaj.org/toc/2044-6055
DOI: 10.1136/bmjopen-2021-057632
Access URL: https://doaj.org/article/ce4bf14e50894ad8b960e1ac7a9e1a39
Accession Number: edsdoj.4bf14e50894ad8b960e1ac7a9e1a39
Database: Directory of Open Access Journals
More Details
ISSN:20446055
DOI:10.1136/bmjopen-2021-057632
Published in:BMJ Open
Language:English