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

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• dc.contributor.author Reyes, Carlen
• dc.contributor.author Sorlí, Luisa
• dc.contributor.author López Montesinos, Inmaculada
• dc.contributor.author Duarte Salles, Talita, 1985-
• dc.date.accessioned 2022-08-02T15:14:39Z
• dc.date.available 2022-08-02T15:14:39Z
• dc.date.issued 2021
• dc.description.abstract 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.
• dc.description.sponsorship This work was supported by several funders as follows: the European Health Data and Evidence Network received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement number 806968. The JU received support from the European Union’s Horizon 2020 research and innovation programme and EFPIA. This research received partial support from the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), US National Institutes of Health (R01 LM006910), US Department of Veterans Affairs, the Health Department from the Generalitat de Catalunya with a grant for research projects on SARS-CoV-2 and COVID-19 disease organised by the Direcció General de Recerca i Innovació en Salut, Janssen Research and Development, TFS, IOMED and IQVIA. The University of Oxford received funding related to this work from the Bill and Melinda Gates Foundation (Investment ID INV-016201 and INV-019257). TFS received funding related to this work from the University of Oxford. This work was also supported with funding (resources and facilities) of the Department of Veterans Affairs (VA) Informatics and Computing Infrastructure (VINCI) (VA HSR RES 13-457).
• dc.format.mimetype application/pdf
• dc.identifier.citation Reyes C, Pistillo A, Fernández-Bertolín S, Recalde M, Roel E, Puente D et al. Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension: a multinational cohort study. BMJ Open. 2021 Dec 22;11(12):e057632. DOI: 10.1136/bmjopen-2021-057632
• dc.identifier.doi http://dx.doi.org/10.1136/bmjopen-2021-057632
• dc.identifier.issn 2044-6055
• dc.identifier.uri http://hdl.handle.net/10230/53908
• dc.language.iso eng
• dc.publisher BMJ Publishing Group
• dc.relation.ispartof BMJ Open. 2021 Dec 22;11(12):e057632
• dc.relation.ispartof BMJ Open. 2021 Dec 22;11(12):e057632
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/806968
• dc.rights © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword COVID-19
• dc.subject.keyword Epidemiology
• dc.subject.keyword Hypertension
• dc.title Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension: a multinational cohort study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion