• Ibrahim El-Battrawy, Ivan J Nuñez-Gil, Mohammad Abumayyaleh, Vicente Estrada, Manuel Becerra-MuñozVíctorVHospital Clínico Universitario Virgen de la Victoria, Málaga, Spain., Aitor Uribarri, Inmaculada Fernández-Rozas, Gisela Feltes, Ramón Arroyo-Espliguero, Daniela Trabattoni, Javier López-País, Martino Pepe, Rodolfo Romero, Alex F Castro-Mejía, Enrico Cerrato, Capel AstruaThamarTHospital Virgen del Mar, Madrid, Spain., Fabrizio D'Ascenzo, Oscar Fabregat-Andres, Jaime Signes-Costa, Francisco Marín, Danilo Buonsenso, Alfredo Bardají, María Jesús Tellez, Antonio Fernández-Ortiz, Carlos Macaya, and Ibrahim Akin.
• University of Mannheim, Mannheim, Germany.
• Eur. J. Clin. Invest. 2021 Nov 1; 51 (11): e13582.

BackgroundA systematic analysis of concomitant arterial hypertension in COVID-19 patients and the impact of angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARBs) have not been studied in a large multicentre cohort yet. We conducted a subanalysis from the international HOPE Registry (https://hopeprojectmd.com, NCT04334291) comparing COVID-19 in presence and absence of arterial hypertension.Materials And MethodsOut of 5837 COVID-19 patients, 2850 (48.8%) patients had the diagnosis arterial hypertension. 1978/2813 (70.3%) patients were already treated with ACEI or ARBs. The clinical outcome of the present subanalysis included all-cause mortality over 40 days of follow-up.ResultsPatients with arterial hypertension suffered significantly more from different complications including respiratory insufficiency (60.8% vs 39.5%), heart failure (9.9% vs 3.1%), acute kidney injury (25.3% vs 7.3%), pneumonia (90.6% vs 86%), sepsis (14.7% vs 7.5%), and bleeding events (3.6% vs 1.6%). The mortality rate was 29.6% in patients with concomitant arterial hypertension and 11.3% without arterial hypertension (P < .001). Invasive and non-invasive respiratory supports were significantly more required in presence of arterial hypertension as compared without it. In the multivariate cox regression analysis, while age≥65, benzodiazepine, antidepressant at admission, elevated LDH or creatinine, respiratory insufficiency and sepsis might be a positive independent predictors of mortality, antiviral drugs, interferon treatment, ACEI or ARBs at discharge or oral anticoagulation at discharge might be an independent negative predictor of the mortality.ConclusionsThe mortality rate and in-hospital complications might be increased in COVID-19 patients with a concomitant history of arterial hypertension. The history of ACEI or ARBs treatments does not seem to impact the outcome of these patients.© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

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