Independent and combined effects of hypertension and diabetes on clinical outcomes in patients with COVID‐19: A retrospective cohort study of Huoshen Mountain Hospital and Guanggu Fangcang Shelter Hospital
| Autor: | Xizhou Guan, Lijing Jia, Ning Xing, Bo Liu, Yuhui Sun, Sibing Zhang, Kunlun He, Liuquan Cheng |
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| Rok vydání: | 2020 |
| Předmět: |
ARDS
medicine.medical_specialty hypertension type 2 diabetes mellitus Endocrinology Diabetes and Metabolism Comorbidity 030204 cardiovascular system & hematology Hospitals Special 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Diabetes Mellitus Internal Medicine Risk of mortality blood glucose Humans Medicine 030212 general & internal medicine Risk factor Retrospective Studies Covid‐19 Original Paper SARS-CoV-2 business.industry blood pressure COVID-19 Type 2 Diabetes Mellitus Retrospective cohort study medicine.disease Blood pressure Respiratory failure Cardiology and Cardiovascular Medicine business Mobile Health Units |
| Zdroj: | The Journal of Clinical Hypertension |
| ISSN: | 1751-7176 1524-6175 |
| DOI: | 10.1111/jch.14146 |
| Popis: | It is widely recognized that hypertension is one of the major risk factor for disease severity and mortality in patients with coronavirus disease 2019 (COVID‐19). However, type 2 diabetes mellitus (T2DM) and hypertension are frequent comorbid conditions, complicating the assessment of hypertension's individual contribution to the risk. The aims of this study were to evaluate the contributions of hypertension alone, T2DM alone, or their combination to the risk of death, acute respiratory distress syndrome (ARDS)/respiratory failure, and severe COVID‐19 infection. Additionally, we assessed risks associated with elevated blood pressure and fasting blood glucose on the same three clinical outcomes. Multivariate logistic models were used for these analyses. Among the 3400 patients, 3327(97.9%) survived and 73(2.1%) died. Compared to patients having neither hypertension nor T2DM (n = 1392), the risk of mortality was significantly higher in patients with T2DM alone (n = 226, OR 5.26 [95% CI: 2.39–11.58]) or with T2DM in combination with hypertension (n = 507, OR 3.02, [95% CI: 1.48–6.15]). Similarly, T2DM was a risk factor for development of ARDS/respiratory failure and severe infection. Hypertension alone (n = 1275) only conferred additional risk for the development of severe infection (OR 1.22 [95% CI: 1.00–1.51]). In conclusion, neither hypertension nor elevated blood pressure was independent risk factors for death or ARDS/respiratory failure but hypertension marginally increased the risk of severe COVID‐19 infection. The risk associated with hypertension is accentuated through its confounding effect on T2DM. |
| Databáze: | OpenAIRE |
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