Abstract：
OBJECTIVE: Hypertension is one of the most common comorbidities in COVID-19 pneumonia. However, whether it is an independent factor on the severity and mortality of COVID-19 has not been studied.
METHODS: In this study, 736 patients with a PCR-confirmed diagnosis of COVID-19 were included from 12 January 2020 to 25 March 2020. All patients were divided into two groups according to whether or not they were hypertensive. After propensity score matching (PSM) to remove the interference of mismatches in the baseline data, the clinical characteristics and outcomes of angiotensin II receptor blocker (ARB)/ACE inhibitors application were analysed.
RESULTS: A total of 220 (29.9%) patients were hypertensive, and 516 (70.1%) patients were not hypertensive. PSM eliminated demographic and comorbidity differences between the two groups. Of all participants, 32 patients died (4.3% mortality), including 17 out of 220 in the hypertension group (7.7%) and 15 out of 516 in the non-hypertension group (2.9%). The incidence of intensive care unit (ICU) stay in the hypertension group (12.8%) was higher than in the non-hypertension group (5.3%) (p<0.05). Logistic regression analysis showed that hypertension was an independent risk factor for death, not other comorbidities. Kaplan-Meier analysis showed that mortality was higher in the hypertension group than in the non-hypertension group before and after PSM (p<0.05). There was no statistically significant difference in ICU therapy, mortality and hospitalisation time between hypertensive patients with or without ARBs/ACE inhibitors (p>0.05).
CONCLUSIONS: Hypertension was an independent risk factor for the severity and mortality of patients with COVID-19. ARBs/ACE inhibitors should not be discontinued in hypertensive patients with COVID-19.
METHODS: In this study, 736 patients with a PCR-confirmed diagnosis of COVID-19 were included from 12 January 2020 to 25 March 2020. All patients were divided into two groups according to whether or not they were hypertensive. After propensity score matching (PSM) to remove the interference of mismatches in the baseline data, the clinical characteristics and outcomes of angiotensin II receptor blocker (ARB)/ACE inhibitors application were analysed.
RESULTS: A total of 220 (29.9%) patients were hypertensive, and 516 (70.1%) patients were not hypertensive. PSM eliminated demographic and comorbidity differences between the two groups. Of all participants, 32 patients died (4.3% mortality), including 17 out of 220 in the hypertension group (7.7%) and 15 out of 516 in the non-hypertension group (2.9%). The incidence of intensive care unit (ICU) stay in the hypertension group (12.8%) was higher than in the non-hypertension group (5.3%) (p<0.05). Logistic regression analysis showed that hypertension was an independent risk factor for death, not other comorbidities. Kaplan-Meier analysis showed that mortality was higher in the hypertension group than in the non-hypertension group before and after PSM (p<0.05). There was no statistically significant difference in ICU therapy, mortality and hospitalisation time between hypertensive patients with or without ARBs/ACE inhibitors (p>0.05).
CONCLUSIONS: Hypertension was an independent risk factor for the severity and mortality of patients with COVID-19. ARBs/ACE inhibitors should not be discontinued in hypertensive patients with COVID-19.
摘要：
目的：高血压是COVID-19肺炎中最常见的合并症之一。然而,它是否是COVID-19严重程度和死亡率的独立因素尚未研究。
方法：在本研究中，从2020年1月12日至2020年3月25日，纳入了736例经PCR确认诊断为COVID-19的患者。所有患者根据是否高血压分为两组。在倾向评分匹配(PSM)以消除基线数据中不匹配的干扰之后,分析血管紧张素II受体阻滞剂(ARB)/ACE抑制剂应用的临床特征和结局.
结果：共有220例（29.9%）高血压患者，516例（70.1%）患者无高血压。PSM消除了两组之间的人口统计学和合并症差异。在所有参与者中，32例患者死亡（4.3%死亡率），包括高血压组220人中的17人(7.7%)和非高血压组516人中的15人(2.9%).高血压组重症监护病房(ICU)住院发生率(12.8%)高于非高血压组(5.3%)(p<0.05)。Logistic回归分析显示高血压是死亡的独立危险因素,不是其他合并症。Kaplan-Meier分析显示,PSM前后高血压组死亡率高于非高血压组(p<0.05)。ICU治疗差异无统计学意义，有或没有ARBs/ACE抑制剂的高血压患者的死亡率和住院时间（p>0.05）。
结论：高血压是COVID-19患者病情严重程度和死亡率的独立危险因素。患有COVID-19的高血压患者不应停用ARBs/ACE抑制剂。
方法：在本研究中，从2020年1月12日至2020年3月25日，纳入了736例经PCR确认诊断为COVID-19的患者。所有患者根据是否高血压分为两组。在倾向评分匹配(PSM)以消除基线数据中不匹配的干扰之后,分析血管紧张素II受体阻滞剂(ARB)/ACE抑制剂应用的临床特征和结局.
结果：共有220例（29.9%）高血压患者，516例（70.1%）患者无高血压。PSM消除了两组之间的人口统计学和合并症差异。在所有参与者中，32例患者死亡（4.3%死亡率），包括高血压组220人中的17人(7.7%)和非高血压组516人中的15人(2.9%).高血压组重症监护病房(ICU)住院发生率(12.8%)高于非高血压组(5.3%)(p<0.05)。Logistic回归分析显示高血压是死亡的独立危险因素,不是其他合并症。Kaplan-Meier分析显示,PSM前后高血压组死亡率高于非高血压组(p<0.05)。ICU治疗差异无统计学意义，有或没有ARBs/ACE抑制剂的高血压患者的死亡率和住院时间（p>0.05）。
结论：高血压是COVID-19患者病情严重程度和死亡率的独立危险因素。患有COVID-19的高血压患者不应停用ARBs/ACE抑制剂。
