Key result
Arterial hypertension is linked to ~3-fold higher hospital mortality versus patients without CVD.
Why the study?
The influence of arterial hypertension and ischemic heart disease at various stages and forms on the course and outcomes of COVID-19 was not well characterized.
Does arterial hypertension and ischemic heart disease increase mortality in COVID-19 patients hospitalized in the ICU?
Cohort (n=808)
No
Does arterial hypertension and ischemic heart disease increase mortality in COVID-19 patients hospitalized in the ICU?
Absolute Event Rate: 12.8% vs 4.5%
p-value: p=0.0008
The presence and severity of arterial hypertension and ischemic heart disease dramatically increase the risk of severe lung involvement, need for mechanical ventilation, and mortality in COVID-19 patients.
Alerts clinicians to higher mortality in hypertensive COVID-19 ICU patients; leaves open whether hypertension independently drives outcomes.
Objective. To investigate the influence of arterial hypertension (AH) and ischemic heart disease (IHD) on the course and outcomes of COVID19, considering their various stages, forms, and target organ involvement.Materials and мethods. A total of 808 COVID19 patients hospitalized in the Intensive Care Unit (ICU) from October 1 to December 31, 2020, aged between 17 and 97 years, were examined. The first group consisted of 246 patients without comorbidities. The second group included 430 patients with AH: 305 with stage II and 125 with stage III. The third group comprised 132 patients with IHD and AH: 84 with angina pectoris, 24 with postinfarction cardiosclerosis, and 24 with acute myocardial infarction (AMI). Clinical and laboratory parameters were assessed for all patients, along with electrocardiography, echocardiography, Doppler ultrasound of the lower extremity veins, and computed tomography (CT) of the thoracic organs. In 110 deceased patients, the severity of lung involvement, signs of heart failure, and the immediate cause of death were evaluated.Results. Among COVID19 patients hospitalized in the ICU, the prevalence of AH was 70%, including 16.5% with IHD, and 22% had concomitant diabetes mellitus. The mortality rate among COVID19 patients without cardiovascular diseases (CVD) was 4.5%. Among those with Stage II AH, including those with IHD and angina, the mortality rates were 8.2% and 14.3%, respectively. In patients with stage III AH with renal or cardiac involvement, mortality rates were 24% and 62.5%, respectively.Conclusion. Risk stratification for mortality, considering the prognostically unfavorable significance of the stages and forms of AH and IHD, as well as concomitant viral infections with respiratory complications, allows for an objective assessment of disease progression and prognosis.
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Keshtova et al. (2025) conducted a cohort in COVID-19 (n=808). Arterial hypertension vs. No cardiovascular diseases was evaluated on Hospital mortality (p=0.0008). Arterial hypertension significantly increased hospital mortality to 12.8% compared to 4.5% in patients without cardiovascular disease (p=0.0008), with even higher mortality in those with concurrent ischemic heart disease.
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