Key Predictors of Inpatient Mortality in COVID-19 Patients

Pavankumar Kamat

Disclosures

July 14, 2021

Takeaway

  • The presence of hypertension and diabetes together was associated with a significantly increased risk of inpatient COVID-19 mortality.

  • Furthermore, advanced age (>65 years), male sex, hypertension and cerebrovascular disease were independently associated with an increased risk of inpatient mortality, irrespective of ethnicity or high social deprivation scores.

Why this matters

  • Findings will help focus clinical attention on all high-risk patients with COVID-19 admitted to the hospital, particularly those with hypertension with or without associated diabetes.

Study design

  • A retrospective, single-center study included 907 patients with COVID-19 (age, >17 years) who were admitted to the hospital between March and May 2020.

  • Funding: Sandwell and West Birmingham National Health Service Trust Research and Development Department.

Key results

  • 60.2% of the patients survived.

  • The presence of diabetes and hypertension together was associated with a greater risk of COVID-19 mortality (OR, 2.75; 95% CI, 1.80-4.21; P<.001) vs hypertension alone (OR, 1.95; 95% CI, 1.26-3.02; P=.003) and diabetes alone (OR, 1.28; 95% CI, 0.66-2.48; P=.463).

  • Advanced age (OR, 3.32; 95% CI, 2.15-5.11), male gender (OR, 2.04; 95% CI, 1.47-2.82), hypertension (OR, 1.69; 95% CI, 1.10-2.61) and cerebrovascular disease (OR, 1.87; 95% CI, 1.31-2.68) were independently associated with an increased risk of mortality.

  • The mortality risk did not differ between the different quintiles of ethnicity and social deprivation.

  • Among biomarkers, high-sensitivity troponin I was the best predictor of mortality (OR, 4.43; 95% CI, 3.10-7.10).

  • Angiotensin-receptor blockers (OR, 0.57; 95% CI, 0.33-0.96) and angiotensin-converting enzyme inhibitors (OR, 0.65; 95% CI, 0.43-0.97) were not associated with adverse outcomes.

Limitations

  • Retrospective design.
     

 

Basu A, Agwu JC, Barlow N, Lee B. Hypertension is the major predictor of poor outcomes among inpatients with COVID-19 infection in the UK: a retrospective cohort study. BMJ Open. 2021;11(6):e047561. doi: 10.1136/bmjopen-2020-047561. PMID: 34172549.  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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