Clinical and laboratory characteristics of COVID-19 in hospitalized hypertensive patients
https://doi.org/10.18705/1607-419X-2023-29-2-150-163
Abstract
Objective. To identify clinical and laboratory differences of COVID-19 in patients with hypertension (HTN), as well as to identify factors associated with its severe course in these patients. Design and methods. A retrospective analysis of case histories of 940 patients with COVID-19 was performed. Statistical analysis was carried out by the method of contingency tables using Pearson's Chi-square test with Bonferroni correction, multiple logistic regression analysis and ROC-analysis were also applied. Results. The group of patients with COVID-19 and HTN showed a number of significant differences compared with the group of patients without HTN history. The study group was characterized by higher rates of females, people over 65, patients with severe COVID-19. They were more likely to have diabetes mellitus, coronary heart disease, and chronic kidney disease. On admission, in the group of HTN patients, leukocytosis and elevated blood glucose levels were more common, as well as pneumonia, shortness of breath and low saturation (p < 0,05). Multivariate logistic regression analysis showed that the presence of coronary heart disease (odds ratio (OR) = 3,492, 95 % confidential interval (CI): 2,016-6,048), leukocytosis (OR = 1,376, 95 % CI: 1,540-7,703), thrombocytopenia (OR = 1,779, 95 % CI: 1,031-3,071) and low SpO2 saturation (OR = 3,265, 95 % CI: 1,996-5,341) were associated with severe COVID-19 in hypertensive patients. ROC-analysis showed that the combination of the identified factors increases power of their association with the severe COVID-19 in HTN patients (AUC = 0,766). Conclusions. 1. Some indicators of hospitalized COVID-19 patients with HTN are different compared to patients with no HTN history. 2. Factors associated with severe COVID-19 in individuals with HTN do not differ from those in the general population of COVID-19 patients. 3. Severe COVID-19 in patients with HTN was strongly associated with the low SpO2 saturation and the presence of concomitant coronary heart disease.
About the Authors
A. A. AbilbayevaKazakhstan
Arailym A. Abilbayeva - MD, Lecturer, Department of General Immunology, the Kazakh National Medical University named after S.D. Asfendiyarov.
94 Tole Bi str., Almaty, 050012
A. S. Tarabayeva
Kazakhstan
Anel S. Tarabayeva - MD, PhD, DSc, Professor, Department of General Immunology, the Kazakh National Medical University named after S.D. Asfendiyarov.
Almaty
G. M. Idrisova
Kazakhstan
Gulzhana M. Idrisova - Master's Student of the 2nd Year of Study in the Specialty “Biomedicine”, the Kazakh National Medical University named after S.D. Asfendiyarov.
Almaty
R. A. Yegemberdiyeva
Kazakhstan
Ravilya A. Yegemberdiyeva - MD, PhD, DSc, Professor, Department of Infectious and Tropical Diseases, the Kazakh National Medical University named after S.D. Asfendiyarov.
Almaty
A. K. Abdrakhmanova
Kazakhstan
Aigul K. Abdrakhmanova - MD, Chief Physician of the City Clinical Infectious Hospital named after I. Zhekenova.
Almaty
A. M. Sadykova
Kazakhstan
Ainur M. Sadykova - MD, PhD, Associate Professor, Department of Infectious and Tropical Diseases, the Kazakh National Medical University named after S. D. Asfendiyarov.
Almaty
A. K. Duisenova
Kazakhstan
Amangul K. Duisenova - MD, PhD, Head, Department of Infectious and Tropical Diseases, the Kazakh National Medical University named after S.D. Asfendiyarov.
Almaty
References
1. Arabi Y, Murthy S, Webb S. COVID-19: a novel coronavirus and a novel challenge for critical care. Intensive Care Med. 2020;46(5):833-836. doi:10.1007/s00134-020-05955-1
2. Zhang JJ, Dong X, Liu GH, Gao YD. Risk and protective factors for COVID-19 morbidity, severity, and mortality. Clinic Rev Allergy Immunol. 2022;1-18. doi:10.1007/s12016-022-08921-5
3. Rodrigues FF, Sa J. COVID-19 infection and arterial hypertension — a reciprocal interaction? J Hypertens. 2022;40(1): e179. doi:10.1097/01.hjh.0000837224.48778.d1
4. Ribeiro AC, Uehara SCDSA. Systemic arterial hypertension as a risk factor for the severe form of COVID-19: scoping review. Revista de saude publica. 2022;56:20. doi:10.11606/s1518-8787.2022056004311
5. Roncon L, Zuin M, Zuliani G, Rigatelli G. Patients with arterial hypertension and COVID-19 are at higher risk of ICU admission. Br J Anaesth. 2020;125(2):e254-e255. doi:10.1016/j.bja.2020.04.056
6. Vintila AM, Horumba MM, Miron P, Balan R, Catrangiu MB, Negoescu IA et al. Arterial hypertension and COVID-19 in hospital mortality. J Hypertens. 2022;40(1):e168. doi:10.1097/01.hjh.0000837068.15495.2f
7. Jordan J, Kurschat C, Reuter H. Arterial hypertension. Dtsch Arztebl Int. 2018;115(33-34):557-568. doi:10.3238/arztebl.2018.0557
8. Chazova IE, Blinova NV, Nevzorova VA, Zhernakova YuV, Savenkov MP, Oshchepkova EV et al. The consensus of experts of the Russian Medical Society on arterial hypertension: arterial hypertension and COVID-19. Syst Hypertens. 2020;17(3):35-41. doi:10.26442/2075082X.2020.3.200362. In Russian.
9. Kadic F, Begic E, Pasic M, Gavrankapetanovic A, Mujakovic A, Pidro A et al. Arterial hypertension in patients with COVID-19 — neural network model. Acta Inform Med. 2022;30(1):25-28. doi:10.5455/aim.2022.30.25-28
10. Pinto IC, Martins D. Prevalence and risk factors of arterial hypertension: a literature review. J Cardiovasc Med Ther. 2017;1(2):1-7. doi:hdl./10198/16934
11. Li X, Guan B, Su T, Liu W, Chen M, Bin Waleed K et al. Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis. Heart. 2020;106(15):1142-1147. doi:10.1136/heartjnl-2020-317062
12. Zhu B, Feng X, Jiang C, Mi S, Yang L, Zhao Z et al. Correlation between white blood cell count at admission and mortality in COVID-19 patients: a retrospective study. BMC Infect Dis. 2021;21(1):574. doi:10.1186/s12879-021-06277-3
13. Wolff D, Nee S, Hickey NS, Marschollek M. Risk factors for COVID-19 severity and fatality: a structured literature review. Infection. 2021;49(1):15-28. doi:10.1007/s15010-020-01509-1
14. Zhang N, Wang C, Zhu F, Mao H, Bai P, Chen LL et al. Risk factors for poor outcomes of diabetes patients with COVID-19: A single-center, retrospective study in early outbreak in China. Front Endocrinol. 2020;11:571037. doi:10.3389/fendo.2020.571037
15. Yan Y, Yang Y, Wang F, Ren H, Zhang S, Shi X et al. Clinical characteristics and outcomes of patients with severe COVID-19 with diabetes. BMJ Open Diabetes Res Care. 2020;8(1):e001343. doi:10.1136/bmjdrc-2020-001343
16. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017;39(5):529-539. doi:10.1007/s00281-017-0629-x
17. Tong X, Cheng A, Yuan X, Zhong X, Wang H, Zhou W et al. Characteristics of peripheral white blood cells in COVID-19 patients revealed by a retrospective cohort study. BMC Infect Dis. 2021;21(1):1236. doi:10.1186/s12879-021-06899-7
18. Feng X, Li S, Sun Q, Zhu J, Chen B, Xiong M et al. Immune-inflammatory parameters in COVID-19 cases: a systematic review and meta-analysis. Front Med. 2020;7:301. doi:10.3389/fmed.2020.00301
19. Jing Liang J, Liu J, Chen Y, Ye B, Li N, Wang X et al. Characteristics of laboratory findings of COVID-19 patients with comorbid diabetes mellitus. Diabetes Res and Clin Pract. 2020;167:108351. doi:10.1016/j.diabres.2020.108351
20. Hana C, Aboulenain S, Dewaswala N, Narendran V. Does thrombocytopenia truly correlate with COVID-19 severity? Blood. 2020;136(1):39-40. doi:10.1182/blood-2020-142440
21. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clin Chim Acta. 2020;506:145-148. doi:10.1016/j.cca.2020.03.022
22. Menezes MCS, Pestana DVS, Gameiro GR, da Silva LFF, Baron Ё, Rouby JJ et al. SARS-CoV-2 pneumonia — receptor binding and lung immunopathology: a narrative review. Crit Care. 2021:25(1): 53. doi:10.1186/s13054-020-03399-z
23. Su WL, Lu KC, Chan CY, Chao YC. COVID-19 and the lungs: a review. J Infect Public Health. 2021;14(11):1708-1714. doi:10.1016/j.jiph.2021.09.024
24. Soto A, Quiñones-Laveriano DM, Azañero J, Chumpitaz R, Claros J, Salazar L et al. Mortality and associated risk factors in patients hospitalized due to COVID-19 in a Peruvian reference hospital. Plos One. 2022;17(3):e0264789. doi:10.1371/journal.pone.0264789
25. Kafan S, Tadbir Vajargah K, Sheikhvatan M, Tabrizi G, Salimzadeh A, Montazeri M et al. Predicting risk score for mechanical ventilation in hospitalized adult patients suffering from COVID-19. Anesth Pain Med. 2021;1(2):e112424. doi:10.5812/aapm.112424
26. Díaz-Vélez C, Urrunaga-Pastor D, Romero-Cerdán A, Peña-Sánchez ER, Fernández Mogollon JL, Cossio Chafloque JD et al. Risk factors for mortality in hospitalized patients with COVID-19 from three hospitals in Peru: a retrospective cohort study. F1000Research. 2021;10:224. doi:10.12688/f1000research.51474.1
27. Stefan G, Mehedinti AM, Andreiana I, Zugravu AD, Cinca S, Busuioc R et al. Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania. Ren Fail. 2021;43(1):49-57. doi:10.1080/0886022X.2020.1853571
28. Morse J, Gay W, Korwek KM, McLean LE, Poland RE, Guy J et al. Hyperglycaemia increases mortality risk in non-diabetic patients with COVID-19 even more than in diabetic patients. Endocrinol Diabetes Metab. 2021;4(4):e00291. doi:10.1002/edm2.291
29. Younossi ZM, Stepanova M, Lam B, Cable R, Felix S, Jeffers T et al. Independent predictors of mortality among patients with NAFLD hospitalized with COVID-19 infection. Hepatol Commun. 2022;6(11):3062-3072. doi:10.1002/hep4.1802
30. Chatterjee NA, Jensen PN, Harris AW, Nguyen DD, Huang HD, Cheng RK et al. Admission respiratory status predicts mortality in COVID-19. Influenza Other Respir Viruses. 2021;15(5):569-579. doi:10.1111/irv.12869
Supplementary files
Review
For citations:
Abilbayeva A.A., Tarabayeva A.S., Idrisova G.M., Yegemberdiyeva R.A., Abdrakhmanova A.K., Sadykova A.M., Duisenova A.K. Clinical and laboratory characteristics of COVID-19 in hospitalized hypertensive patients. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2023;29(2):150-163. (In Russ.) https://doi.org/10.18705/1607-419X-2023-29-2-150-163