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

Carlen Reyes; Andrea Pistillo; Sergio Fernández-Bertolín; Martina Recalde; Elena Roel; Diana Puente; Anthony G. Sena; Clair Blacketer; Lana Lai; Thamir M. Alshammari; Waheed Ui Rahman Ahmed; Osaid Alser; Heba Alghoul; Carlos Areia; Dalia Dawoud; Albert Prats-Uribe; Neus Valveny; Gabriel De Maeztu; Luisa Sorlí Redó; Jordi Martinez Roldan; Inmaculada Lopez Montesinos; Lisa M. Schilling; Asieh Golozar; Christian Reich; Jose D. Posada; Nigam Shah; Seng Chan You; Kristine E. Lynch; Scott L. Duvall; Michael E. Matheny; Fredrik Nyberg; Anna Ostropolets; George Hripcsak; Peter R. Rijnbeek; Marc A. Suchard; Patrick Ryan; Kristin Kostka; Talita Duarte-Salles

doi:10.1136/bmjopen-2021-057632

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

Carlen Reyes
, Andrea Pistillo
, Sergio Fernández-Bertolín
, Martina Recalde
, Elena Roel
, Diana Puente
, Anthony G. Sena
, Clair Blacketer
, Lana Lai
, Thamir M. Alshammari
, Waheed Ui Rahman Ahmed
, Osaid Alser
, Heba Alghoul
, Carlos Areia
, Dalia Dawoud
, Albert Prats-Uribe
, Neus Valveny
, Gabriel De Maeztu
, Luisa Sorlí Redó
, Jordi Martinez Roldan

Inmaculada Lopez Montesinos, Lisa M. Schilling, Asieh Golozar, Christian Reich, Jose D. Posada, Nigam Shah, Seng Chan You, Kristine E. Lynch, Scott L. Duvall, Michael E. Matheny, Fredrik Nyberg, Anna Ostropolets, George Hripcsak, Peter R. Rijnbeek, Marc A. Suchard, Patrick Ryan, Kristin Kostka, Talita Duarte-Salles^*

^*Corresponding author for this work

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Research output: Contribution to journal › Article › Academic › peer-review

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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.

Original language	English
Article number	e057632
Journal	BMJ Open
Volume	11
Issue number	12
DOIs	https://doi.org/10.1136/bmjopen-2021-057632
Publication status	Published - 22 Dec 2021

Bibliographical note

Funding Information:
Competing interests SLD reports grants from Anolinx. MAS reports grants from US National Institutes of Health, grants from Department of Veterans Affairs, during the conduct of the study; grants from IQVIA, personal fees from Janssen Research and Development, grants from US Food and Drug Administration, personal fees from Private Health Management, outside the submitted work. GH reports grants from NIH, during the conduct of the study; and grants from Janssen Research, outside the submitted work. FN reports being an employee of AstraZeneca until 2019 and holds some AstraZeneca shares, outside the submitted work. KK reports personal fees from the National Institutes of Health, outside the submitted work, and at the time of data analysis and initial drafting of the manuscript. KK was an employee of IQVIA. CRei reports he is an employee of IQVIA. GdM is an employee of IOMED. NV is an employee of TFS. AGS reports personal fees from Janssen R&D, outside the submitted work, and is a full-time employee of Janssen R&D and a Johnson and Johnson shareholder. CB reports personal fees from Janssen R&D, outside the submitted work, and is a full-time employee of Janssen R&D and a Johnson and Johnson shareholder. JDP reports grants from the National Library of Medicine, during the conduct of the study. AG is an employee of Regeneron Pharmaceuticals and reports stocks from Regeneron Pharmaceuticals. PRR reports having received research group grants from Innovative Medicine Initiative and Janssen Research and Development. PR reports being an employee of Janssen Research and Development and a shareholder of Johnson & Johnson. ER, SF-B, NS, LMS, DP, SCY, MR, AP-U, HA, KEL, MEM, AO, CA, CRey, TD-S, TMA, OA, W-U-RA, ILM, JMR, LSR, DD, LL and AP have nothing to declare. No other relationships or activities could appear to have influenced the submitted work.

Funding Information:
Funding 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).

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© 2021 BMJ Publishing Group. All rights reserved.

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Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertensionFinal published version, 3.09 MBLicence: CC BY

Cite this

Reyes, C., Pistillo, A., Fernández-Bertolín, S., Recalde, M., Roel, E., Puente, D., Sena, A. G., Blacketer, C., Lai, L., Alshammari, T. M., Ahmed, W. U. R., Alser, O., Alghoul, H., Areia, C., Dawoud, D., Prats-Uribe, A., Valveny, N., De Maeztu, G., Sorlí Redó, L., ... Duarte-Salles, T. (2021). Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension: A multinational cohort study. BMJ Open, 11(12), Article e057632. https://doi.org/10.1136/bmjopen-2021-057632

@article{2cced6158a0d48e4a7b7c7cdde02af40,

title = "Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension: A multinational cohort study",

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.",

author = "Carlen Reyes and Andrea Pistillo and Sergio Fern{\'a}ndez-Bertol{\'i}n and Martina Recalde and Elena Roel and Diana Puente and Sena, \{Anthony G.\} and Clair Blacketer and Lana Lai and Alshammari, \{Thamir M.\} and Ahmed, \{Waheed Ui Rahman\} and Osaid Alser and Heba Alghoul and Carlos Areia and Dalia Dawoud and Albert Prats-Uribe and Neus Valveny and \{De Maeztu\}, Gabriel and \{Sorl{\'i} Red{\'o}\}, Luisa and \{Martinez Roldan\}, Jordi and \{Lopez Montesinos\}, Inmaculada and Schilling, \{Lisa M.\} and Asieh Golozar and Christian Reich and Posada, \{Jose D.\} and Nigam Shah and You, \{Seng Chan\} and Lynch, \{Kristine E.\} and Duvall, \{Scott L.\} and Matheny, \{Michael E.\} and Fredrik Nyberg and Anna Ostropolets and George Hripcsak and Rijnbeek, \{Peter R.\} and Suchard, \{Marc A.\} and Patrick Ryan and Kristin Kostka and Talita Duarte-Salles",

note = "Funding Information: Competing interests SLD reports grants from Anolinx. MAS reports grants from US National Institutes of Health, grants from Department of Veterans Affairs, during the conduct of the study; grants from IQVIA, personal fees from Janssen Research and Development, grants from US Food and Drug Administration, personal fees from Private Health Management, outside the submitted work. GH reports grants from NIH, during the conduct of the study; and grants from Janssen Research, outside the submitted work. FN reports being an employee of AstraZeneca until 2019 and holds some AstraZeneca shares, outside the submitted work. KK reports personal fees from the National Institutes of Health, outside the submitted work, and at the time of data analysis and initial drafting of the manuscript. KK was an employee of IQVIA. CRei reports he is an employee of IQVIA. GdM is an employee of IOMED. NV is an employee of TFS. AGS reports personal fees from Janssen R\&D, outside the submitted work, and is a full-time employee of Janssen R\&D and a Johnson and Johnson shareholder. CB reports personal fees from Janssen R\&D, outside the submitted work, and is a full-time employee of Janssen R\&D and a Johnson and Johnson shareholder. JDP reports grants from the National Library of Medicine, during the conduct of the study. AG is an employee of Regeneron Pharmaceuticals and reports stocks from Regeneron Pharmaceuticals. PRR reports having received research group grants from Innovative Medicine Initiative and Janssen Research and Development. PR reports being an employee of Janssen Research and Development and a shareholder of Johnson \& Johnson. ER, SF-B, NS, LMS, DP, SCY, MR, AP-U, HA, KEL, MEM, AO, CA, CRey, TD-S, TMA, OA, W-U-RA, ILM, JMR, LSR, DD, LL and AP have nothing to declare. No other relationships or activities could appear to have influenced the submitted work. Funding Information: Funding 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{\textquoteright}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 Direcci{\'o} General de Recerca i Innovaci{\'o} 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). Publisher Copyright: {\textcopyright} 2021 BMJ Publishing Group. All rights reserved.",

year = "2021",

month = dec,

day = "22",

doi = "10.1136/bmjopen-2021-057632",

language = "English",

volume = "11",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "12",

}

Reyes, C, Pistillo, A, Fernández-Bertolín, S, Recalde, M, Roel, E, Puente, D, Sena, AG , Blacketer, C, Lai, L, Alshammari, TM, Ahmed, WUR, Alser, O, Alghoul, H, Areia, C, Dawoud, D, Prats-Uribe, A, Valveny, N, De Maeztu, G, Sorlí Redó, L, Martinez Roldan, J, Lopez Montesinos, I, Schilling, LM, Golozar, A, Reich, C, Posada, JD, Shah, N, You, SC, Lynch, KE, Duvall, SL, Matheny, ME, Nyberg, F, Ostropolets, A, Hripcsak, G, Rijnbeek, PR, Suchard, MA, Ryan, P, Kostka, K & Duarte-Salles, T 2021, 'Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension: A multinational cohort study', BMJ Open, vol. 11, no. 12, e057632. https://doi.org/10.1136/bmjopen-2021-057632

TY - JOUR

T1 - Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension

T2 - A multinational cohort study

AU - Reyes, Carlen

AU - Pistillo, Andrea

AU - Fernández-Bertolín, Sergio

AU - Recalde, Martina

AU - Roel, Elena

AU - Puente, Diana

AU - Sena, Anthony G.

AU - Blacketer, Clair

AU - Lai, Lana

AU - Alshammari, Thamir M.

AU - Ahmed, Waheed Ui Rahman

AU - Alser, Osaid

AU - Alghoul, Heba

AU - Areia, Carlos

AU - Dawoud, Dalia

AU - Prats-Uribe, Albert

AU - Valveny, Neus

AU - De Maeztu, Gabriel

AU - Sorlí Redó, Luisa

AU - Martinez Roldan, Jordi

AU - Lopez Montesinos, Inmaculada

AU - Schilling, Lisa M.

AU - Golozar, Asieh

AU - Reich, Christian

AU - Posada, Jose D.

AU - Shah, Nigam

AU - You, Seng Chan

AU - Lynch, Kristine E.

AU - Duvall, Scott L.

AU - Matheny, Michael E.

AU - Nyberg, Fredrik

AU - Ostropolets, Anna

AU - Hripcsak, George

AU - Rijnbeek, Peter R.

AU - Suchard, Marc A.

AU - Ryan, Patrick

AU - Kostka, Kristin

AU - Duarte-Salles, Talita

N1 - Funding Information: Competing interests SLD reports grants from Anolinx. MAS reports grants from US National Institutes of Health, grants from Department of Veterans Affairs, during the conduct of the study; grants from IQVIA, personal fees from Janssen Research and Development, grants from US Food and Drug Administration, personal fees from Private Health Management, outside the submitted work. GH reports grants from NIH, during the conduct of the study; and grants from Janssen Research, outside the submitted work. FN reports being an employee of AstraZeneca until 2019 and holds some AstraZeneca shares, outside the submitted work. KK reports personal fees from the National Institutes of Health, outside the submitted work, and at the time of data analysis and initial drafting of the manuscript. KK was an employee of IQVIA. CRei reports he is an employee of IQVIA. GdM is an employee of IOMED. NV is an employee of TFS. AGS reports personal fees from Janssen R&D, outside the submitted work, and is a full-time employee of Janssen R&D and a Johnson and Johnson shareholder. CB reports personal fees from Janssen R&D, outside the submitted work, and is a full-time employee of Janssen R&D and a Johnson and Johnson shareholder. JDP reports grants from the National Library of Medicine, during the conduct of the study. AG is an employee of Regeneron Pharmaceuticals and reports stocks from Regeneron Pharmaceuticals. PRR reports having received research group grants from Innovative Medicine Initiative and Janssen Research and Development. PR reports being an employee of Janssen Research and Development and a shareholder of Johnson & Johnson. ER, SF-B, NS, LMS, DP, SCY, MR, AP-U, HA, KEL, MEM, AO, CA, CRey, TD-S, TMA, OA, W-U-RA, ILM, JMR, LSR, DD, LL and AP have nothing to declare. No other relationships or activities could appear to have influenced the submitted work. Funding Information: Funding 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). Publisher Copyright: © 2021 BMJ Publishing Group. All rights reserved.

PY - 2021/12/22

Y1 - 2021/12/22

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/85122323993

U2 - 10.1136/bmjopen-2021-057632

DO - 10.1136/bmjopen-2021-057632

M3 - Article

C2 - 34937726

AN - SCOPUS:85122323993

SN - 2044-6055

VL - 11

JO - BMJ Open

JF - BMJ Open

IS - 12

M1 - e057632

ER -

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

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