Blood parameters, symptoms at presentation and adverse in-hospital outcomes of COVID-19 pneumonia in patients with hypertension

Shaghee, F.; Nafakhi, H.; Buthabhak, K. A.; Alareedh, M.; Nafakhi, A.; Kasim, S.; Al-Buthabhak, K.

Background: We aimed to explore the association of clinical symptoms of COVID-19 pneumonia, blood parameters on admission, and anti-hypertensive drugs with in-hospital outcomes, including length of hospital and intensive care unit (ICU) stay, receiving mechanical ventilation, degree of lung injury, and in-hospital death among patients with hypertension. Material and methods: This retrospective study conducted in patients with newly diagnosed COVID-19 pneumonia from August 20, 2020 to September 25, 2020. Results: A total of 182 patients with COVID-19 pneumonia were included in the present study. The patients were categorized into those with hypertension (n = 82) or without hypertension (n = 100). Patients on angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) showed no significant increase in the risk for all in-hospital outcomes. Old age [0.6 (0.5 2) p 0.00], fever [0.3 (0.2 1.8), p 0.00] and low lymphocytes percentage [0.3 (0.2 1.2), p 0.00] were associated with increased risk for extensive lung injury. Old age [0.4 (0.1 = 0.7) p 0.01], high neutrophil count [0.3 (0.2 2), p = 0.02] and low lymphocyte percentage [0.3 (0.1 0.7), p = 0.01] were associated with prolonged hospital stay while low lymphocytes percentage [0.7 (0.6 0.9), p 0.00], old age [1.2 (1 1.4), p = 0.01] and fatigue [2 (1 4), p = 0.04] showed significant association with prolonged length of ICU stay. Low lymphocytes percentage [0.7 (0.6 1), p 0.00], old age [1.1 (1 1.2), p = 0.01] and fatigue [2 (1.7 4), p = 0.02] were associated with increased risk for receiving mechanical ventilation. Risk for in-hospital death was associated with increased neutrophil percentage [1.2 (1 1.5), p = 0.01] and old age [1.1 (1 1.2), p = 0.03]. Conclusions: ARBs and ACEIs showed no significant association with adverse in-hospital outcomes. Old age, low lymphocytes percentage and high neutrophils percentage on admission were independent predictors for increased risk of in-hospital mortality and morbidity among COVID-19 pneumonia patients with hypertension.