Hypertension as a prognostic factor in the prediction of mortality in patients with COVID-19: A systematic review and meta-analysis

Jose Ronilo  G. Juangco,; Carmela  D. Pagdanganan,; Uriel Gem  A. Paguio,; Maria Angelica  C. Palaspas,; Nina Rose  G. Palmares,; Jonaima  S. Panalondong,; Vita Iris  A. Salvacion,; Louriz Maveric  S. Samonte,; Pia Loraine  P. San Felipe,; Maria Emelyn  P. San Miguel,; Patricia Anne  C. San Pedro,; Izza Anamiel  V. Sanchez,; Mary Ann  D. San Juan,

Hypertension as a prognostic factor in the prediction of mortality in patients with COVID-19: A systematic review and meta-analysis

Abstract:

Introduction Hypertension was identified by the CDC to be one of underlying medical conditions that might pose an increased risk for severe illness from COVID-19. This study aimed to determine the effect of hypertension on the morbidity of COVID-19 patients to help physicians in adjusting the management plans for a better prognosis. Methods Participants included all COVID-19 patients with hypertension as a pre-existing medical condition. Studies were selected based study design, participants, exposure, outcome, timing, setting and language. MEDLINE and CINAHL, ScienceDirect, Clinical Key, OVID database, Wiley Online library, and UpToDate were searched. The risk of bias in selection, comparability and outcomes were evaluated. All information gathered were collated and evaluated using the Newcastle-Ottawa Quality Assessment Scale and CEBM. Results There was a statistically significant positive association between mortality and hypertension as a prognostic factor (OR = 5.25, 95% CI 2.42, 11.40; HR = 2.21, 95% CI 1.75, 2.80). Individual studies all showed a significant relationship between hypertension and mortality in COVID-19 patients with OR ranging from 1.75 to 28.88, and HR of 1.49 to 3.32. Conclusion Hypertension as a comorbid condition is a significant prognostic factor in the prediction of mortality in hospitalized COVID-19 patients.

References:

COVID-19 FAQS [Internet]. Department of Health website. 2020 [updated 2020 Mar 02; cited 2020 Oct 04]. Available from: https://www.doh.gov.ph/COVID-19/FAQs
COVID 19, understanding your risk, medical conditions. [Internet]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Cited 2020 October 04.
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ [Internet]. 2021; 372: n71.doi:10.1136/bmj.n71
Welcome to REVMAN 5.4. REVMAN training [Internet] Available from: https://training.cochrane.org/system/files/uploads/protected_file/RevMan5.4_user_guide.pdf. Cited 2020 Oct 04.
CEBM prognosis worksheet, Critical Appraisal Tools CEBM [Internet]. Available from: https://www.cebm.net/wp-content/uploads/2014/04/cebm-prognosis-worksheet.pdf. Cited 2020 Oct 04.
Newcastle–Ottawa Quality Assessment Form [Internet]. Available from: https://www.google.com/l?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjuoq3u_35AhWKs1YBHV0GC7YQFnoECAUQAQ&url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fbooks%2FNBK115843%2Fbin%2Fappe-fm3.pdf&usg=AOvVaw3rBog32aIb1VDjaGkEn_Kg. Cited 2020 Oct 04.
Juangco J, Ramilo-Cruz N, Cruz R, et al. Effectiveness of Saccharomyces boulardii on diarrhea, a systematic review and meta-analysis. UERMMMCI Health Sci J [Internet]. 2021 Jan-Jun; 10(1): 16-24. Available from: https://uerm.edu.ph/Forms/research/HSJ%20vol.10no.1%202021.pdf#page=21
Zhu H, Wei L, Niu P. The novel coronavirus outbreak in Wuhan, China. Glob Health Res Policy 2020; 5(6). Available from: https://doi.org/10.1186/s41256-020-00135-6
Xiong T-Y, Huang F-Y, Liu Q, et al. Hypertension is a risk factor for adverse outcomes in patients with coronavirus disease 2019: A cohort study. Ann Med [Internet]. 2020 Nov; 52(7): 361-6. doi: 10.1080/07853890.2020.1802059
Iaccarino G, Grassi G, Borghi C, et al. Age and multimorbidity predict death among COVID-19 patients: Results of the SARS-RAS Study of the Italian Society of Hypertension. Hypertension [Internet]. 2020 Aug; 76(2):366-72. doi: 10.1161/HYPERTENSIONAHA.120.15324
Lippi G, Wong J, Henry BM. Hypertension and its severity or mortality in coronavirus disease 2019 (COVID-19): A pooled analysis. Pol Arch Intern Med [Internet]. 2020 Apr 30; 130(4): 304-9. doi: 10.20452/pamw.15272
Lippi G, Henry BM. Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19). Resp Med [Internet]. 2020; 167:105941. Available from: https://doi.org/10.1016/j.rmed.2020.105941.
Henry BM, Lippi G. Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. Int Urol Nephrol [Internet]. 2020 Jun; 52(6): 1193-4. doi: 10.1007/s11255-020-02451-9
Yang Q, Zhou Y, Wang X, et al. Effect of hypertension on outcomes of adult inpatients with COVID-19 in Wuhan, China: A propensity score–matching analysis. Respir Res [Internet]. 2020; 21(172): https://doi.org/10.1186/s12931-020-01435-8