Association of hypertension with the severity and fatality of SARS-CoV-2 infection: A meta-analysis

• Published in: Epidemiology and infection Vol. 148; p. e106
• Main Authors: Zhang, Jingqi, Wu, Jing, Sun, Xiaohua, Xue, Hong, Shao, Jianguo, Cai, Weihua, Jing, Yang, Yue, Ming, Dong, Chen
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 01-01-2020
• Subjects: Blood pressure; Coronavirus Infections - mortality; Coronavirus Infections - physiopathology; Coronaviruses; COVID-19; Disease transmission; Fatalities; Heterogeneity; Humans; Hypertension; Hypertension - epidemiology; Infections; Medical diagnosis; Meta-analysis; Original Paper; Pandemics; Pneumonia; Pneumonia, Viral - mortality; Pneumonia, Viral - physiopathology; Quality; Risk Factors; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Statistical analysis; Studies; Viral diseases; China; COVID-19; severity; SARS-CoV-2; fatality; hypertension
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S095026882000117X

Hypertension is a common comorbidity in COVID-19 patients. However, the association of hypertension with the severity and fatality of COVID-19 remain unclear. In the present meta-analysis, relevant studies reported the impacts of hypertension on SARS-CoV-2 infection were identified by searching PubMed, Elsevier Science Direct, Web of Science, Wiley Online Library, Embase and CNKI up to 20 March 2020. As the results shown, 12 publications with 2389 COVID-19 patients (674 severe cases) were included for the analysis of disease severity. The severity rate of COVID-19 in hypertensive patients was much higher than in non-hypertensive cases (37.58% vs 19.73%, pooled OR: 2.27, 95% CI: 1.80-2.86). Moreover, the pooled ORs of COVID-19 severity for hypertension vs. non-hypertension was 2.21 (95% CI: 1.58-3.10) and 2.32 (95% CI: 1.70-3.17) in age <50 years and ⩾50 years patients, respectively. Additionally, six studies with 151 deaths of 2116 COVID-19 cases were included for the analysis of disease fatality. The results showed that hypertensive patients carried a nearly 3.48-fold higher risk of dying from COVID-19 (95% CI: 1.72-7.08). Meanwhile, the pooled ORs of COVID-19 fatality for hypertension vs. non-hypertension was 6.43 (95% CI: 3.40-12.17) and 2.66 (95% CI: 1.27-5.57) in age <50 years and ⩾50 years patients, respectively. Neither considerable heterogeneity nor publication bias was observed in the present analysis. Therefore, our present results provided further evidence that hypertension could significantly increase the risks of severity and fatality of SARS-CoV-2 infection.