Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression.

IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Journal of the Renin-Angiotensin-Aldosterone System Pub Date : 2020-04-01 DOI:10.1177/1470320320926899
Raymond Pranata, Michael Anthonius Lim, Ian Huang, Sunu Budhi Raharjo, Antonia Anna Lukito
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Abstract

Objective: To investigate the association between hypertension and outcome in patients with Coronavirus Disease 2019 (COVID-19) pneumonia.

Methods: We performed a systematic literature search from several databases on studies that assess hypertension and outcome in COVID-19. Composite of poor outcome, comprising of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care and disease progression were the outcomes of interest.

Results: A total of 6560 patients were pooled from 30 studies. Hypertension was associated with increased composite poor outcome (risk ratio (RR) 2.11 (95% confidence interval (CI) 1.85, 2.40), p < 0.001; I2, 44%) and its sub-group, including mortality (RR 2.21 (1.74, 2.81), p < 0.001; I2, 66%), severe COVID-19 (RR 2.04 (1.69, 2.47), p < 0.001; I2 31%), ARDS (RR 1.64 (1.11, 2.43), p = 0.01; I2,0%, p = 0.35), ICU care (RR 2.11 (1.34, 3.33), p = 0.001; I2 18%, p = 0.30), and disease progression (RR 3.01 (1.51, 5.99), p = 0.002; I2 0%, p = 0.55). Meta-regression analysis showed that gender (p = 0.013) was a covariate that affects the association. The association was stronger in studies with a percentage of males < 55% compared to ⩾ 55% (RR 2.32 v. RR 1.79).

Conclusion: Hypertension was associated with increased composite poor outcome, including mortality, severe COVID-19, ARDS, need for ICU care and disease progression in patients with COVID-19.

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高血压与 COVID-19 肺炎死亡率和病情严重程度的增加有关:系统回顾、荟萃分析和荟萃回归。
目的研究冠状病毒病 2019(COVID-19)肺炎患者的高血压与预后之间的关系:我们在多个数据库中对评估 COVID-19 患者高血压和预后的研究进行了系统性文献检索。包括死亡率、重症 COVID-19、急性呼吸窘迫综合征(ARDS)、重症监护室(ICU)护理需求和疾病进展在内的综合不良预后是我们关注的结果:结果:共汇总了 30 项研究中的 6560 名患者。高血压与综合不良预后增加有关(风险比 (RR) 2.11 (95% 置信区间 (CI) 1.85, 2.40),P < 0.001; I2, 44%),其亚组包括死亡率 (RR 2.21 (1.74, 2.81),P < 0.001; I2, 66%)、严重 COVID-19 (RR 2. 04 (1.69, 2.81),P < 0.001; I2, 44%)。04 (1.69, 2.47), p < 0.001; I2 31%), ARDS (RR 1.64 (1.11, 2.43), p = 0.01; I2,0%, p = 0.35), ICU 护理 (RR 2.11 (1.34, 3.33), p = 0.001; I2 18%, p = 0.30), 和疾病进展 (RR 3.01 (1.51, 5.99), p = 0.002; I2 0%, p = 0.55)。元回归分析表明,性别(p = 0.013)是影响相关性的协变量。男性比例小于 55% 的研究与 ⩾ 55% 的研究相比,关联性更强(RR 2.32 v. RR 1.79):高血压与COVID-19患者的综合不良预后增加有关,包括死亡率、严重COVID-19、ARDS、ICU护理需求和疾病进展。
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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
16
审稿时长
6-12 weeks
期刊介绍: JRAAS is a peer-reviewed, open access journal, serving as a resource for biomedical professionals, primarily with an active interest in the renin-angiotensin-aldosterone system in humans and other mammals. It publishes original research and reviews on the normal and abnormal function of this system and its pharmacology and therapeutics, mostly in a cardiovascular context but including research in all areas where this system is present, including the brain, lungs and gastro-intestinal tract.
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