Abstract: PO0070
The Role of Hypertension in Incidence and Morbidity of COVID-19: A One-Year Review in US Veterans
Session Information
- COVID-19: Epidemiology, Outcomes, Complications, and Risk Factors
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Cristiano, Elizabeth, Kansas City VA Hospital, Kansas City, Missouri, United States
- Garcia-Touza, Mariana, Kansas City VA Hospital, Kansas City, Missouri, United States
- Wiegmann, Peter Sigurd, Kansas City VA Hospital, Kansas City, Missouri, United States
- Sharma, Mukut, Kansas City VA Hospital, Kansas City, Missouri, United States
- Savin, Virginia J., Kansas City VA Hospital, Kansas City, Missouri, United States
- Sharma, Ram, Kansas City VA Hospital, Kansas City, Missouri, United States
- Singh, Vikas, Kansas City VA Hospital, Kansas City, Missouri, United States
- Wiegmann, Thomas, Kansas City VA Hospital, Kansas City, Missouri, United States
Background
The discovery that ACE2 was a co-receptor of COVID-19 as well as early clinical findings induced interest in the role of hypertension (HTN) and its treatment with angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) with regard to COVID-19 incidence and morbidity. We examined the effect of demographic and common risk factors of HTN and treatment with ACEI, ARBs, calcium channel blockers (CCB) and beta blockers (BB) in patients with COVID-19.
Methods
The VA COVID resource data combines hospital data, administrative and clinical record search results. The prevalence of HTN was defined by its presence in the last 2 years prior to COVID-19 testing. New event (incidence) was determined as occurrence within 60 days thereafter. ACEI and ARB, and CCB and BB were combined, basic demographic and risk factors were categorized for comparisons. Data sets were propensity matched, statistical analysis (SAS enterprise guide 7.1) used frequency distributions (chi square). The data was limited to the first year of collection.
Results
Of 1,305,466 veterans, we found positive tests (18.1%), HTN (56.9%), ACE or ARB (33.7%), and CCB or BB (15.4%). HTN and treatment had no effect on COVID-19 incidence (OR HTN 1.08, ACE/ARB 1.01, CCB/BB 0.94). White, male patients aged over 60 years predominated. Age, race, and smoking had no effect on incidence, but DM2 (OR 1.2) and higher BMI (OR 1.4) did. We then examined demographics and risk factors in the COVID-19 positive HTN population. Male gender (5.4), age > 60 years (7.5), race non-white (1.6), BMI >30 (2), smoker (2.8), and DM2 (11.8). In turn, these factors at most affected outcomes (OR) such as all-cause mortality (7.9), admissions (2.1), ICU admissions (2.5), and ventilator use (2.7) with the exception of BMI which was associated with improved outcomes (0.6). ACEI or ARB had no effect (< 1.1) while CCB or BB had a small effect (1.26) on outcome.
Conclusion
In conclusion, HTN and anti-hypertensive treatment had no effect on COVID-19 incidence. HTN is associated with age, race, smoking and a diagnosis of DM2. Treatment with ACEI or ARB has no effect on morbidity while CCB or BB had a small effect that deserves further evaluation.
Funding
- Veterans Affairs Support