Key result
Admission pulse pressure ≥60 mmHg is linked to ~27% higher in-hospital mortality in COVID-19.
Why the study?
Older age and cardiovascular comorbidities are known risk factors for mortality in COVID-19, but the impact of arterial stiffness on in-hospital mortality was unclear.
Cohort (n=12,170)
Yes
Admission pulse pressure ≥60 mm Hg was associated with higher COVID-19 mortality; hypothesis-generating for arterial stiffness as a prognostic marker.
Older age and cardiovascular comorbidities are well-known risk factors for all-cause mortality in patients with coronavirus disease 2019 (COVID-19). Hypertension and age are the 2 principal determinants of arterial stiffness (AS). This study aimed to estimate AS in patients with COVID-19 requiring hospitalization and analyze its association with all-cause in-hospital mortality. This observational, retrospective, multicenter cohort study analyzed 12 170 patients admitted to 150 Spanish centers included in the SEMI-COVID-19 Network. We compared AS, defined as pulse pressure ≥60 mm Hg, and clinical characteristics between survivors and nonsurvivors. Mean age was 67.5 (±16.1) years and 42.5% were women. Overall, 2606 (21.4%) subjects died. Admission systolic blood pressure (BP) <120 and ≥140 mm Hg was a predictor of higher all-cause mortality (23.5% and 22.8%, respectively, P <0.001), compared with systolic BP between 120 and 140 mm Hg (18.6%). The 4379 patients with AS (36.0%) were older and had higher systolic and lower diastolic BP. Multivariate analysis showed that AS and systolic BP <120 mm Hg significantly and independently predicted all-cause in-hospital mortality (adjusted odds ratio [ORadj]: 1.27, P =0.0001; ORadj: 1.48, P =0.0001, respectively) after adjusting for sex (males, ORadj: 1.6, P =0.0001), age tertiles (second and third tertiles, ORadj: 2.0 and 4.7, P =0.0001), Charlson Comorbidity Index (second and third tertiles, ORadj: 4.8 and 8.6, P =0.0001), heart failure, and previous and in-hospital antihypertensive treatment. Our data show that AS and admission systolic BP <120 mm Hg had independent prognostic value for all-cause mortality in patients with COVID-19 requiring hospitalization.
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Rodilla et al. (2020) conducted a cohort in COVID-19 requiring hospitalization (n=12,170). Arterial stiffness (pulse pressure ≥60 mm Hg) vs. No arterial stiffness (pulse pressure <60 mm Hg) was evaluated on All-cause in-hospital mortality (OR 1.27, p=0.0001). Arterial stiffness, estimated by an admission pulse pressure ≥60 mm Hg, independently predicted an increased risk of all-cause in-hospital mortality (adjusted OR 1.27, P=0.0001) in patients with COVID-19.
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