Raymond Pranata, Michael Anthonius Lim, Ian Huang, Sunu Budhi Raharjo, Antonia Anna Lukito
{"title":"高血压与 COVID-19 肺炎死亡率和病情严重程度的增加有关：系统回顾、荟萃分析和荟萃回归。","authors":"Raymond Pranata, Michael Anthonius Lim, Ian Huang, Sunu Budhi Raharjo, Antonia Anna Lukito","doi":"10.1177/1470320320926899","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between hypertension and outcome in patients with Coronavirus Disease 2019 (COVID-19) pneumonia.</p><p><strong>Methods: </strong>We performed a systematic literature search from several databases on studies that assess hypertension and outcome in COVID-19. Composite of poor outcome, comprising of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care and disease progression were the outcomes of interest.</p><p><strong>Results: </strong>A total of 6560 patients were pooled from 30 studies. Hypertension was associated with increased composite poor outcome (risk ratio (RR) 2.11 (95% confidence interval (CI) 1.85, 2.40), <i>p</i> < 0.001; <i>I</i><sup>2</sup>, 44%) and its sub-group, including mortality (RR 2.21 (1.74, 2.81), <i>p</i> < 0.001; <i>I</i><sup>2</sup>, 66%), severe COVID-19 (RR 2.04 (1.69, 2.47), <i>p</i> < 0.001; <i>I</i><sup>2</sup> 31%), ARDS (RR 1.64 (1.11, 2.43), <i>p</i> = 0.01; <i>I</i><sup>2</sup>,0%, <i>p</i> = 0.35), ICU care (RR 2.11 (1.34, 3.33), <i>p</i> = 0.001; <i>I</i><sup>2</sup> 18%, <i>p</i> = 0.30), and disease progression (RR 3.01 (1.51, 5.99), <i>p</i> = 0.002; <i>I</i><sup>2</sup> 0%, <i>p</i> = 0.55). Meta-regression analysis showed that gender (<i>p</i> = 0.013) was a covariate that affects the association. The association was stronger in studies with a percentage of males < 55% compared to ⩾ 55% (RR 2.32 v. RR 1.79).</p><p><strong>Conclusion: </strong>Hypertension was associated with increased composite poor outcome, including mortality, severe COVID-19, ARDS, need for ICU care and disease progression in patients with COVID-19.</p>","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 2","pages":"1470320320926899"},"PeriodicalIF":2.1000,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/bb/10.1177_1470320320926899.PMC7231906.pdf","citationCount":"0","resultStr":"{\"title\":\"Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression.\",\"authors\":\"Raymond Pranata, Michael Anthonius Lim, Ian Huang, Sunu Budhi Raharjo, Antonia Anna Lukito\",\"doi\":\"10.1177/1470320320926899\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the association between hypertension and outcome in patients with Coronavirus Disease 2019 (COVID-19) pneumonia.</p><p><strong>Methods: </strong>We performed a systematic literature search from several databases on studies that assess hypertension and outcome in COVID-19. Composite of poor outcome, comprising of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care and disease progression were the outcomes of interest.</p><p><strong>Results: </strong>A total of 6560 patients were pooled from 30 studies. Hypertension was associated with increased composite poor outcome (risk ratio (RR) 2.11 (95% confidence interval (CI) 1.85, 2.40), <i>p</i> < 0.001; <i>I</i><sup>2</sup>, 44%) and its sub-group, including mortality (RR 2.21 (1.74, 2.81), <i>p</i> < 0.001; <i>I</i><sup>2</sup>, 66%), severe COVID-19 (RR 2.04 (1.69, 2.47), <i>p</i> < 0.001; <i>I</i><sup>2</sup> 31%), ARDS (RR 1.64 (1.11, 2.43), <i>p</i> = 0.01; <i>I</i><sup>2</sup>,0%, <i>p</i> = 0.35), ICU care (RR 2.11 (1.34, 3.33), <i>p</i> = 0.001; <i>I</i><sup>2</sup> 18%, <i>p</i> = 0.30), and disease progression (RR 3.01 (1.51, 5.99), <i>p</i> = 0.002; <i>I</i><sup>2</sup> 0%, <i>p</i> = 0.55). Meta-regression analysis showed that gender (<i>p</i> = 0.013) was a covariate that affects the association. The association was stronger in studies with a percentage of males < 55% compared to ⩾ 55% (RR 2.32 v. RR 1.79).</p><p><strong>Conclusion: </strong>Hypertension was associated with increased composite poor outcome, including mortality, severe COVID-19, ARDS, need for ICU care and disease progression in patients with COVID-19.</p>\",\"PeriodicalId\":17330,\"journal\":{\"name\":\"Journal of the Renin-Angiotensin-Aldosterone System\",\"volume\":\"21 2\",\"pages\":\"1470320320926899\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2020-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/bb/10.1177_1470320320926899.PMC7231906.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Renin-Angiotensin-Aldosterone System\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/1470320320926899\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Renin-Angiotensin-Aldosterone System","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/1470320320926899","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression.
Objective: To investigate the association between hypertension and outcome in patients with Coronavirus Disease 2019 (COVID-19) pneumonia.
Methods: We performed a systematic literature search from several databases on studies that assess hypertension and outcome in COVID-19. Composite of poor outcome, comprising of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care and disease progression were the outcomes of interest.
Results: A total of 6560 patients were pooled from 30 studies. Hypertension was associated with increased composite poor outcome (risk ratio (RR) 2.11 (95% confidence interval (CI) 1.85, 2.40), p < 0.001; I2, 44%) and its sub-group, including mortality (RR 2.21 (1.74, 2.81), p < 0.001; I2, 66%), severe COVID-19 (RR 2.04 (1.69, 2.47), p < 0.001; I2 31%), ARDS (RR 1.64 (1.11, 2.43), p = 0.01; I2,0%, p = 0.35), ICU care (RR 2.11 (1.34, 3.33), p = 0.001; I2 18%, p = 0.30), and disease progression (RR 3.01 (1.51, 5.99), p = 0.002; I2 0%, p = 0.55). Meta-regression analysis showed that gender (p = 0.013) was a covariate that affects the association. The association was stronger in studies with a percentage of males < 55% compared to ⩾ 55% (RR 2.32 v. RR 1.79).
Conclusion: Hypertension was associated with increased composite poor outcome, including mortality, severe COVID-19, ARDS, need for ICU care and disease progression in patients with COVID-19.
期刊介绍：
JRAAS is a peer-reviewed, open access journal, serving as a resource for biomedical professionals, primarily with an active interest in the renin-angiotensin-aldosterone system in humans and other mammals. It publishes original research and reviews on the normal and abnormal function of this system and its pharmacology and therapeutics, mostly in a cardiovascular context but including research in all areas where this system is present, including the brain, lungs and gastro-intestinal tract.
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