Impact of Hypertension and Antihypertensive Treatment on COVID-19 Severity: A Retrospective Observational Study in Ternopil Region, Ukraine.

Background: Hypertension (HP) may significantly affect the prognosis of COVID-19 illness. Understanding the epidemiological and clinical characteristics of post-COVID-19 patients with HP and other comorbidities is important for improving outcomes.

Methods: We conducted a retrospective observational study in the Ternopil region of Ukraine involving 926 subjects: 848 individuals in the post-COVID period (0-90 days after a negative SARS-CoV-2 PCR test) and 78 (8.4%) in a control group. Data on medical history, clinical manifestations, treatment modalities, and pathomorphological findings were collected. Patients were categorized into four groups based on COVID-19 severity: mild, moderate, severe, and critical.

Results: HP was present in 46.2% of patients, with a prevalence of 75.0% among fatal cases (p<0.001). Diabetes mellitus (DM) was diagnosed in 17.6%. HP was not associated with increased susceptibility to SARS-CoV-2 infection. In-hospital mortality risk significantly correlated with age (r=0.306, p<0.001), HP (r=0.145, p=0.001), DM (r=0.144, p=0.001), combined HP and DM (r=0.159, p<0.001), and irregular antihypertensive treatment (r=-0.118, p=0.037). However, regular use of ACE inhibitors or ARBs did not significantly affect prognosis. Multivariable logistic regression identified age and irregular antihypertensive treatment as independent predictors of in-hospital mortality.

Conclusion: HP was not associated with increased susceptibility to SARS-CoV-2 infection, based on similar prevalence rates in patients and controls, but was linked to worse outcomes when combined with other risk factors. Age and irregular antihypertensive treatment emerged as independent predictors of in-hospital mortality. These findings highlight the importance of regular blood pressure management in reducing the severity and improving the prognosis of COVID-19 in hypertensive patients.