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Published on: April 18, 2025
Predictors of mortality among hospitalized hypertensive patients with COVID-19 during third and fourth waves in
Narendar Kumar1, Siti M Sheikh Ghadzi1, Pushp L Rajpoot2
1Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia.
Insights
Hypertension increases COVID-19 severity and mortality risk. Older age, higher pulse rate, elevated creatinine, and mechanical ventilation predict death in hypertensive COVID-19 patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Hypertension is a significant risk factor for severe COVID-19 outcomes, including mortality and prolonged hospitalization.
- Existing data on mortality predictors in hypertensive COVID-19 patients is still evolving.
- Understanding these predictors is crucial for improving patient management and outcomes.
Purpose of the Study:
- To investigate the independent predictors of mortality among hospitalized patients with hypertension and COVID-19.
- To identify clinical characteristics associated with adverse survival outcomes in this patient cohort.
Main Methods:
- A single-center cohort study involving 333 hospitalized hypertensive COVID-19 patients.
- Data collected between April 1, 2021, and October 31, 2021.
- Multivariate logistic regression analysis was employed to identify mortality predictors.
Main Results:
- Independent predictors of mortality included older age (≥ 65 years), elevated pulse rate, and increased serum creatinine.
- Use of antibiotics, corticosteroids, and need for respiratory support (high flow oxygen, non-invasive or invasive mechanical ventilation) were significant predictors.
- Age ≥ 65 years (aOR 20.89) and invasive mechanical ventilation (aOR 379.54) showed the highest odds ratios for mortality.
Conclusions:
- Older age, elevated pulse rate, serum creatinine, antibiotic and corticosteroid use, and need for mechanical ventilation are key predictors of mortality in hypertensive COVID-19 patients.
- These findings highlight the critical role of age and respiratory support in determining survival.
- The study underscores the importance of close monitoring and aggressive management for high-risk hypertensive COVID-19 patients.
Introduction:
Hypertension significantly contributes to the severity and mortality of COVID-19 patients. It has also been a risk factor for prolonged hospitalization and the need for intensive care. However, the data is still evolving. Therefore, this study investigated the predictors of mortality among hypertensive COVID-19 patients.
Methodology:
A single-center cohort study was performed at Indus Hospital and Health Network, Karachi, Pakistan, between April 1, 2021, and October 31, 2021. This study included 333 hospitalized hypertensive COVID-19 patients and evaluated their clinical characteristics and survival outcomes. A multivariate logistic regression model was applied in IBM SPSS 27.0 to determine the predictors of mortality.
Results:
The majority of patients were females (54.7%), the median age was 62 [55-70] years, with co-existing diabetes (56.5%) and severely ill (52.6%). The independent predictors of mortality identified were age ≥ 65 years (aOR 20.89, 95% CI, 5.81-75.15; p < 0.001), pulse rate (aOR 1.03, 95% CI 1.01-1.63; p = 0.006), serum creatinine (aOR 1.34, 95% CI 1.11-1.63; p = 0.002), use of antibiotics (aOR 3.40, 95% CI 1.29-8.98; p = 0.014)), corticosteroid (aOR 49.68, 95% CI 1.83-1350.31; p = 0.020), and who needed high flow oxygen supply (aOR 13.08, 95% CI 1.70-100.54; p < 0.001), non-invasive mechanical ventilation (aOR 229.01, 95% CI 29.30-1789.71; p < 0.001) and invasive mechanical ventilation (aOR 379.54, 95% CI 36.60-3935.87; p < 0.001).
Conclusions:
Our study suggests that older age, elevated pulse rate, serum creatinine, use of antibiotics and corticosteroids, and the need for mechanical ventilation predict mortality among hypertensive COVID-19.
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