Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University.
Guangdong Provincial Key Laboratory of Shock and Microcirculation, School of Basic Medical Sciences, Southern Medical University.
Int Heart J. 2021 Mar 30;62(2):337-343. doi: 10.1536/ihj.20-323. Epub 2021 Mar 6.
It is unclear whether patients with hypertension are more likely to be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general population and whether there is a difference in the severity of coronavirus disease (COVID-19) pneumonia in patients who have taken ACEI/ARB drugs compared with those who have not.This observational study included data from all patients with clinically confirmed COVID-19 admitted to Hankou Hospital, Wuhan, China, between January 5 and March 8, 2020. Data were extracted from clinical and laboratory records. Follow-up was cut off on March 8, 2020.A total of 274 patients, 75 with hypertension and 199 without hypertension, were included in the analysis. Compared with patients without hypertension, patients with hypertension were older and were more likely to have preexisting comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease. Moreover, patients with hypertension tended to have higher positive rate for SARS-CoV-2 PCR detection. Multivariate logistic regression analysis showed that age (P = 0.005) and gender (P = 0.019) were independent risk factors associated with the severity of pneumonia in patients on admission, whereas ACEI/ARB treatment (P = 0.184) was not.Patients with COVID-19 with hypertension were significantly older and were more likely to have underlying comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease. ACEI/ARB drugs did not influence the severity of pneumonia in patients with SARS-CoV-2. In future studies, a larger sample size and multi-center clinical data would be needed to support these conclusions.
尚不清楚高血压患者是否比一般人群更容易感染严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2),以及服用 ACEI/ARB 药物的 COVID-19 肺炎患者与未服用 ACEI/ARB 药物的患者相比,其肺炎严重程度是否存在差异。这项观察性研究纳入了 2020 年 1 月 5 日至 3 月 8 日期间在中国武汉汉口医院收治的所有临床确诊的 COVID-19 患者的数据。数据从临床和实验室记录中提取。随访于 2020 年 3 月 8 日截止。共纳入 274 例患者,其中 75 例患有高血压,199 例未患有高血压。与无高血压患者相比,高血压患者年龄较大,且更有可能患有既往合并症,包括慢性肾功能不全、心血管疾病、糖尿病和脑血管疾病。此外,高血压患者 SARS-CoV-2 PCR 检测阳性率较高。多因素 logistic 回归分析显示,年龄 (P = 0.005) 和性别 (P = 0.019) 是入院时肺炎严重程度的独立危险因素,而 ACEI/ARB 治疗 (P = 0.184) 不是。COVID-19 合并高血压的患者年龄明显较大,且更有可能患有基础合并症,包括慢性肾功能不全、心血管疾病、糖尿病和脑血管疾病。ACEI/ARB 药物并不影响 SARS-CoV-2 患者肺炎的严重程度。未来的研究需要更大的样本量和多中心临床数据来支持这些结论。