Outcome of COVID-19 infection in patients on antihypertensives: A cross-sectional study.

Sakthivadivel Varatharajan, Gopal K Bohra, Pradeep K Bhatia, Satyendra Khichar, Mahadev Meena, Naveenraj Palanisamy, Archana Gaur, Mahendra K Garg
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Abstract

Background: Patients with coronavirus disease 2019 (COVID-19) infection frequently have hypertension as a co-morbidity, which is linked to adverse outcomes. Antihypertensives may affect the outcome of COVID-19 infection.

Aim: To assess the effects of antihypertensive agents on the outcomes of COVID-19 infection.

Methods: A total of 260 patients were included, and their demographic data and clinical profile were documented. The patients were categorized into nonhypertensive, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB), calcium channel blocker (CCB), a combination of ACEI/ARB and CCB, and beta-blocker groups. Biochemical, hematological, and inflammatory markers were measured. The severity of infection, intensive care unit (ICU) intervention, and outcome were recorded.

Results: The mean age of patients was approximately 60-years-old in all groups, except the nonhypertensive group. Men were predominant in all groups. Fever was the most common presenting symptom. Acute respiratory distress syndrome was the most common complication, and was mostly found in the CCB group. Critical cases, ICU intervention, and mortality were also higher in the CCB group. Multivariable logistic regression analysis revealed that age, duration of antihypertensive therapy, erythrocyte sedimentation rate, high-sensitivity C-reactive protein, and interleukin 6 were significantly associated with mortality. The duration of antihypertensive therapy exhibited a sensitivity of 70.8% and specificity of 55.7%, with a cut-off value of 4.5 years and an area under the curve of 0.670 (0.574-0.767; 95% confidence interval) for COVID-19 outcome.

Conclusion: The type of antihypertensive medication has no impact on the clinical sequence or mortality of patients with COVID-19 infection. However, the duration of antihypertensive therapy is associated with poor outcomes.

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服用降压药的患者感染 COVID-19 的结果:横断面研究
背景:冠状病毒病2019(COVID-19)感染患者经常合并高血压,这与不良预后有关。抗高血压药物可能会影响COVID-19感染的预后。目的:评估抗高血压药物对COVID-19感染预后的影响:方法:共纳入 260 例患者,记录他们的人口统计学数据和临床概况。患者被分为非高血压组、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂(ACEI/ARB)组、钙通道阻滞剂(CCB)组、ACEI/ARB 和 CCB 联合用药组和β-受体阻滞剂组。对生化指标、血液指标和炎症指标进行了测定。记录了感染的严重程度、重症监护室(ICU)的干预情况和结果:除非高血压组外,其他各组患者的平均年龄约为 60 岁。所有组别均以男性为主。发热是最常见的首发症状。急性呼吸窘迫综合征是最常见的并发症,主要发生在 CCB 组。CCB 组的危重病例、重症监护室干预和死亡率也更高。多变量逻辑回归分析显示,年龄、降压治疗持续时间、红细胞沉降率、高敏C反应蛋白和白细胞介素6与死亡率显著相关。降压治疗持续时间的敏感性为 70.8%,特异性为 55.7%,临界值为 4.5 年,COVID-19 结果的曲线下面积为 0.670(0.574-0.767;95% 置信区间):结论:降压药物的类型对COVID-19感染患者的临床序列或死亡率没有影响。结论:降压药物的种类对COVID-19感染患者的临床序列和死亡率没有影响,但降压治疗的持续时间与不良预后有关。
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