Investigation of symptoms and mortality in hypertension patients diagnosed with COVID-19: A retrospective case-control study

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COVID-19, Hypertension, symptom


It was aimed to determine whether there is a difference in mortality and symptoms between patients, aged 60 years or above, with hypertension (HT) and Coronavirus disease 2019 (COVID-19) infection and those without any chronic disease. The population of the study, which was conducted as a retrospective case-control study, consisted of 2747 HT patients diagnosed with COVID-19 and aged 60 years or above. While 170 patients with HT diagnosis formed the case group, 170 patients without any chronic disease formed the control group from the sample. In this study, the time from diagnosis to death was found to be shorter in the presence of HT in COVID-19 patients, while males diagnosed with COVID-19 had higher rates of intensive care unit admittance, intubation and mortality than females irrespective of HT. The presence of HT was determined not to affect symptoms in patients diagnosed with COVID-19. The most common symptoms were fatigue, cough, body ache, fever, headache, and sore throat in HT and control groups and the symptoms were similar in both groups. Further studies are recommended to reveal the relationship between HT, considered one of the most important risk factors for COVID-19, and adverse outcomes related to COVID-19.


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Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2019 update: A report from the American Heart Association. Circulation. 2019; 139(10):e56-e528. doi: 10.1161/CIR.0000000000000659.

Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223-37. doi: 10.1038/s41581-019-0244-2.

World Health Organization (2023). Coronavirus disease (COVID-19) outbreak. Retrieved from

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33. doi: 10.1056/NEJMoa2001017.

Deng SQ, Peng HJ. Characteristics of and public health responses to the coronavirus disease 2019 outbreak in China. J Clin Med. 2020;9(2):575. doi: 10.3390/jcm9020575.

Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi: 10.1056/NEJMoa2002032.

Peng YD, Meng K, Guan HQ, Leng L, Zhu RR, Wang BY, et al. Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV. Zhonghua Xin Xue Guan Bing Za Zhi. 2020;48(6):450-5. doi: 10.3760/cma.j.cn112148-20200220-00105.

Lian J, Jin X, Hao S, Cai H, Zhang S, Zheng L, et al. Analysis of epidemiological and clinical features in older patients with coronavirus disease 2019 (COVID-19) outside Wuhan. Clin Infect Dis. 2020;71(15):740-7. doi: 10.1093/cid/ciaa242.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-ınfected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. doi: 10.1001/jama.2020.1585.

Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531-8. doi: 10.1007/s00392-020-01626-9.

Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac ınjury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802-10. doi: 10.1001/jamacardio.2020.0950.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395(10229):1054-62. doi: 10.1016/S0140-6736(20)30566-3.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.

Deng Y, Liu W, Liu K, Fang YY, Shang J, Zhou L, et al. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 in Wuhan, China: A retrospective study. Chin Med J (Engl). 2020;133(11):1261-7. doi: 10.1097/CM9.0000000000000824.

Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934-43. doi: 10.1001/jamainternmed.2020.0994.

Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):811-8. doi: 10.1001/jamacardio.2020.1017.

Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: Retrospective study. BMJ. 2020;368: m1091. doi: 10.1136/bmj.m1091.

Donoghue M, Hsieh F, Baronas E, Godbout K, Gosselin M, Stagliano N, et al. A novel angiotensin-converting enzyme-related carboxypeptidase (ACE2) converts angiotensin I to angiotensin 1-9. Circ Res. 2000;87(5):E1-9. doi: 10.1161/01.res.87.5.e1.

Jiang F, Yang J, Zhang Y, Dong M, Wang S, Zhang Q, et al. Angiotensin-converting enzyme 2 and angiotensin 1-7: Novel therapeutic targets. Nat Rev Cardiol. 2014;11(7):413-26. doi: 10.1038/nrcardio.2014.59.

Imai Y, Kuba K, Rao S, Huan Y, Guo F, Guan B, et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature. 2005;436(7047):112-6. doi: 10.1038/nature03712.

Patel VB, Zhong JC, Grant MB, Oudit GY. Role of the ACE2/angiotensin 1-7 axis of the renin-angiotensin system in heart failure. Circ Res. 2016;118(8):1313-26. doi: 10.1161/CIRCRESAHA.116.307708.

Wrapp D, Wang N, Corbett KS, Goldsmith JA, Hsieh CL, Abiona O, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science. 2020;367(6483):1260-3. doi: 10.1126/science.abb2507.

Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, Marelli-Berg FM, et al. COVID-19 and the cardiovascular system: Implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020;116(10):1666-87. doi: 10.1093/cvr/cvaa106.

Badawi A, Ryoo SG. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): A systematic review and meta-analysis. Int J Infect Dis. 2016;49:129-33. doi: 10.1016/j.ijid.2016.06.015.

Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of underlying diseases in hospitalized patients with COVID-19: A systematic review and meta-analysis. Arch Acad Emerg Med. 2020;8(1):e35.

Peña JE, Rascón-Pacheco RA, Ascencio-Montiel IJ, González-Figueroa E, Fernández-Gárate JE, Medina-Gómez OS, et al. Hypertension, diabetes and obesity, major risk factors for death in patients with COVID-19 in Mexico. Arch Med Res. 2021;52(4):443-9. doi: 10.1016/j.arcmed.2020.12.002

Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020;133(9):1025-31. doi: 10.1097/CM9.0000000000000744.

Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-5. doi: 10.1016/j.ijid.2020.03.017.

Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81. doi: 10.1016/S2213-2600(20)30079-5.

Du Y, Tu L, Zhu P, Mu M, Wang R, Yang P, et al. Clinical features of 85 fatal cases of COVID-19 from Wuhan: A retrospective observational study. Am J Respir Crit Care Med. 2020;201(11):1372-9. doi: 10.1164/rccm.202003-0543OC.

Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846-8. doi: 10.1007/s00134-020-05991-x

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. doi: 10.1001/jama.2020.2648.

Barrera FJ, Shekhar S, Wurth R, Moreno-Pena PJ, Ponce OJ, Hajdenberg M, et al. Prevalence of diabetes and hypertension and their associated risks for poor outcomes in COVID-19 patients. J Endocr Soc. 2020;4(9):bvaa102. doi: 10.1210/jendso/bvaa102.

Du Y, Zhou N, Zha W, Lv Y. Hypertension is a clinically important risk factor for critical illness and mortality in COVID-19: A meta-analysis. Nutr Metab Cardiovasc Dis. 2021;31(3):745-55. doi: 10.1016/j.numecd.2020.12.009.

Pranata R, Lim MA, Huang I, Raharjo SB, Lukito AA. Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression. J Renin Angiotensin Aldosterone Syst. 2020;21(2):1470320320926899. doi: 10.1177/1470320320926899.

Chen Y., Gong X., Wang L., Guo J. Effects of hypertension, diabetes and coronary heart disease on COVID-19 diseases severity: a systematic review and meta-analysis. medRxiv. 2020; doi: 10.1101/2020.03.25.20043133. (preprint).

Chen C, Yan JT, Zhou N, Zhao JP, Wang DW. Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19 [Article in Chinese]. Zhonghua Xin Xue Guan Bing Za Zhi. 2020;48(7):567-71. doi: 10.3760/cma.j.cn112148-20200225-00123.

Shaghee F, Nafakhi H, Al-Buthabhak K, Alareedh M, Nafakhi A, Kasim S. Blood parameters, symptoms at presentation and adverse in-hospital outcomes of COVID-19 pneumonia in patients with hypertension. Arterial Hypertens. 2021;25(1):7-13. doi: 10.5603/AH.a2021.0004

Chengyi HU, Lushan X, Hongbo Z, Yanpei Z, Wenfeng Z, Li L, et al. Effect of hypertension on outcomes of patients with COVID-19 [Article in Chinese]. Nan Fang Yi Ke Da Xue Xue Bao. 2020;40(11):1537-42. doi: 10.12122/j.issn.1673-4254.2020.11.01.

Chen F, Sun W, Sun S, Li Z, Wang Z, Yu L. Clinical characteristics and risk factors for mortality among inpatients with COVID‐19 in Wuhan, China. Clin Transl Med. 2020;10(2):e40. doi: 10.1002/ctm2.40.

Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020;395(10239):1763-70. doi: 10.1016/S0140-6736(20)31189-2.

Wang D, Yin Y, Hu C, Liu X, Zhang X, Zhou S, et al. Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China. Crit Care. 2020;24(1):188. doi: 10.1186/s13054-020-02895-6.

Henry BM, Vikse J, Benoit S, Favaloro EJ, Lippi G. Hyperinflammation and derangement of renin-angiotensin-aldosterone system in COVID-19: A novel hypothesis for clinically suspected hypercoagulopathy and microvascular immunothrombosis. Clin Chim Acta. 2020;507:167-73. doi: 10.1016/j.cca.2020.04.027.

Vepa A, Bae JP, Ahmed F, Pareek M, Khunti K. COVID-19 and ethnicity: A novel pathophysiological role for inflammation. Diabetes Metab Syndr. 2020;14(5):1043-51. doi: 10.1016/j.dsx.2020.06.056.

De Miguel C, Rudemiller NP, Abais JM, Mattson DL. Inflammation and hypertension: new understandings and potential therapeutic targets. Curr Hypertens Rep. 2015;17(1):507. doi: 10.1007/s11906-014-0507-z.

Kulcsar KA, Coleman CM, Beck SE, Frieman MB. Comorbid diabetes results in immune dysregulation and enhanced disease severity following MERS-CoV infection. JCI Insight. 2019;4(20): e131774. doi: 10.1172/jci.insight.131774.




How to Cite

Uyar, S., Yalçınkaya, Z., Eti Aslan, F., & Yalın, H. (2024). Investigation of symptoms and mortality in hypertension patients diagnosed with COVID-19: A retrospective case-control study. HEALTH SCIENCES QUARTERLY, 4(1), 21–30.



Original Article