Association Between Hypertension and Diabetes Control and COVID‐19 Severity: National Patient‐Centered Clinical Research Network, United States, March 2020 to February 2022-Reference-Cited by-同舟云学术

Association Between Hypertension and Diabetes Control and COVID‐19 Severity: National Patient‐Centered Clinical Research Network, United States, March 2020 to February 2022

Published:2023-11-07 Issue:21 Volume:12 Page:
ISSN:2047-9980
Container-title:Journal of the American Heart Association
language:en
Short-container-title:JAHA

Author:

Jackson Sandra L.¹^ORCID,Woodruff Rebecca C.¹^ORCID,Nagavedu Kshema²,Fearrington Julia²,Rolka Deborah B.³^ORCID,Twentyman Evelyn⁴^ORCID,Carton Thomas W.⁵^ORCID,Puro Jon⁶,Denson Joshua L.⁷^ORCID,Kappelman Michael D.⁸^ORCID,Paranjape Anuradha⁹^ORCID,Thacker Deepika¹⁰^ORCID,Weiner Mark G.¹¹^ORCID,Goodman Alyson B.¹²,Lekiachvili Akaki¹³,Boehmer Tegan K.¹⁴^ORCID,Block Jason P.¹⁵,Ahmad Faraz S.,Blecker Saul,Bunnell H. Timothy,Chang Bernard P.,Chrischilles Elizabeth A.,Christakis Dimitri A.,Cowell Lindsay G.,Curtis Janis L.,Fort Daniel,Hanauer David A,Hess Rachel,Horne Benjamin D.,Giordano Philip,Hogan William,Hwang Wenke,Lehmann Harold,Mayer Kenneth H.,Mosa Abu Saleh Mohammad,McClay James C.,Nandhakumar Samyuktha,Nolan Bridget,Obeid Jihad S.,Ostasiewski Brian,Pajor Nathan M.,Patel Lav,Rao Suchitra,Robinson Patricia S.,Silverstein Jonathan C.,Stoddard Alexander,Trick William E.

Affiliation:

1. Division for Heart Disease and Stroke Prevention National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta GA

2. Department of Population Medicine Harvard Pilgrim Health Care Institute, Harvard Medical School Boston MA

3. Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta GA

4. Office of the Director National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention Atlanta GA

5. Louisiana Public Health Institute New Orleans LA

6. OCHIN, Inc. Portland OR

7. Section of Pulmonary, Critical Care, and Environmental Medicine Tulane University School of Medicine New Orleans LA

8. Department of Pediatrics, UNC School of Medicine The University of North Carolina at Chapel Hill Chapel Hill NC

9. Temple University Philadelphia PA

10. Nemours Cardiac Center Wilmington DE

11. Department of Population Health Sciences Weill Cornell Medicine New York NY

12. Division of Nutrition, Physical Activity, and Obesity National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta GA

13. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta GA

14. Office of Public Health Data, Surveillance, and Technology Centers for Disease Control and Prevention Atlanta GA

15. Division of Chronic Disease Research Across the Lifecourse (CoRAL) Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School Boston MA

Abstract

Background Hypertension and diabetes are associated with increased COVID‐19 severity. The association between level of control of these conditions and COVID‐19 severity is less well understood. Methods and Results This retrospective cohort study identified adults with COVID‐19, March 2020 to February 2022, in 43 US health systems in the National Patient‐Centered Clinical Research Network. Hypertension control was categorized as blood pressure (BP) <130/80, 130 to 139/80 to 89, 140 to 159/90 to 99, or ≥160/100 mm Hg, and diabetes control as glycated hemoglobin <7%, 7% to <9%, ≥9%. Adjusted, pooled logistic regression assessed associations between hypertension and diabetes control and severe COVID‐19 outcomes. Among 1 494 837 adults with COVID‐19, 43% had hypertension and 12% had diabetes. Among patients with hypertension, the highest baseline BP was associated with greater odds of hospitalization (adjusted odds ratio [aOR], 1.30 [95% CI, 1.23–1.37] for BP ≥160/100 versus BP <130/80), critical care (aOR, 1.30 [95% CI, 1.21–1.40]), and mechanical ventilation (aOR, 1.32 [95% CI, 1.17–1.50]) but not mortality (aOR, 1.08 [95% CI, 0.98–1.12]). Among patients with diabetes, the highest glycated hemoglobin was associated with greater odds of hospitalization (aOR, 1.61 [95% CI, 1.47–1.76] for glycated hemoglobin ≥9% versus <7%), critical care (aOR, 1.42 [95% CI, 1.31–1.54]), mechanical ventilation (aOR, 1.12 [95% CI, 1.02–1.23]), and mortality (aOR, 1.18 [95% CI, 1.09–1.27]). Black and Hispanic adults were more likely than White adults to experience severe COVID‐19 outcomes, independent of comorbidity score and control of hypertension or diabetes. Conclusions Among 1.5 million patients with COVID‐19, higher BP and glycated hemoglobin were associated with more severe COVID‐19 outcomes. Findings suggest that adults with poorest control of hypertension or diabetes might benefit from efforts to prevent and initiate early treatment of COVID‐19.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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