高血压与糖尿病控制与COVID-19严重程度之间的关联:国家以患者为中心的临床研究网络,美国,2020年3月至2022年2月
Sandra L Jackson1, Rebecca C Woodruff1, Kshema Nagavedu2
1Division for Heart Disease and Stroke Prevention National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta GA.
Journal of the American Heart Association
|October 18, 2023
概括
控制不良的高血压和糖尿病增加了COVID-19严重结果的风险,包括住院和重症监护. 保持良好的血压和糖化血红蛋白水平对于更好的COVID-19预后至关重要.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
背景情况:
- 高血压和糖尿病是已知的严重COVID-19的危险因素.
- 这些慢性病的控制水平对COVID-19严重性的影响需要进一步调查.
研究的目的:
- 评估高血压和糖尿病的控制水平与COVID-19结果的严重程度之间的关联.
- 为了确定与COVID-19严重程度增加相关的特定血压和糖化血红蛋白值.
主要方法:
- 在43个美国卫生系统 (2020年3月 - 2022年2月) 中,对1,494,837名患有COVID-19的成年人进行了回顾性队列研究.
- 按基线血压 (BP) 水平分类的高血压控制.
- 根据糖化血红蛋白 (HbA1c) 水平分类的糖尿病控制.
- 后勤回归分析以确定严重的COVID-19结果的调整几率比率 (aOR).
主要成果:
- 在高血压患者中,较高的基线血压 (≥160/100 mmHg) 与住院 (aOR 1.30),重症监护 (aOR 1.30) 和机械通风 (aOR 1.32) 的几率增加有关.
- 在糖尿病患者中,较高的HbA1c (≥9%) 与住院几率 (aOR 1.61),重症监护 (aOR 1.42),机械通风 (aOR 1.12) 和死亡率 (aOR 1.18) 的增加有关.
- 与白人成年人相比,黑人和西班牙裔成年人面临的严重COVID-19结果的风险更高,独立于并发症控制.
结论:
- 高血压 (高血压) 和糖尿病 (高HbA1c) 的低最佳控制显著增加了严重COVID-19结果的风险.
- 这些发现强调了管理高血压和糖尿病对于减轻COVID-19严重性的重要性.
- 针对COVID-19的有针对性的预防和早期治疗策略可能有利于控制不良的高血压或糖尿病患者.
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