Association between hypertension and prognosis of patients with COVID-19: A systematic review and meta-analysis

ABSTRACT

Background

To investigate the association between hypertension and clinical outcomes, including in-hospital mortality, intensive care unit (ICU) admission, and invasive ventilation in patients with coronavirus disease 2019 (COVID-19) pneumonia.

Methods

We implemented a systematic search of PubMed for articles that assessed clinical outcomes of hypertensive patients infected with SARS-CoV-2. The primary outcomes evaluated included: in-hospital mortality, ICU admission, and the use of invasive ventilation.

Results

A total of 18 studies were included, involving 13,293 patients and covering from January 25, 2020, to April 20, 2020. The relationship between hypertension and prognosis in COVID-19 patients was evaluated. Results showed that hypertension was a risk factor for in-hospital mortality in COVID-19 patients (RR: 2.20, 95% CI, 1.83–2.65, P < .001). Moreover, patients with hypertension were more likely to be admitted to ICU (RR: 1.86, 95% CI, 1.13–3.07, P = .001) and to use invasive ventilation (RR: 2.99, 95% CI, 1.73–5.17, P < .001).

Conclusions

Among COVID-19 patients, those combined with hypertension had a significantly higher risk of in-hospital deaths, admission to ICU, and need for invasive ventilation.

KEYWORDS:

• COVID-19
• epidemiology
• hypertension
• respiratory infections
• virology

Abbreviations

ACEI, Angiotensin-converting-enzyme inhibitor; ACE2, Angiotensin-converting enzyme 2; ARB, Angiotensin II receptor blocker; ICU, Intensive care unit; RAAS, Renin-angiotensin-aldosterone system; RR, Risk ratio; SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2; WHO, World Health Organization.

Authors’ contributions

SC, ZQ, and JP designed and guided the study. ZQ and SC wrote the manuscript. ZL and QG prepared all tables and data analysis. All authors reviewed the manuscript, and read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by grants from the Clinical Research Startup Program of Southern Medical University by High-level University Construction Funding of Guangdong Provincial Department of Education (No. LC2016PY003). The funding sources did not have any influence on the study design, data collection, analysis, and interpretation of the data, writing of the manuscript, or decision to submit for publication.