Abstract
Older age and cardiovascular comorbidities are well-known risk factors for all-cause mortality in patients with coronavirus disease 2019 (COVID-19). Hypertension and age are the 2 principal determinants of arterial stiffness (AS). This study aimed to estimate AS in patients with COVID-19 requiring hospitalization and analyze its association with all-cause in-hospital mortality. This observational, retrospective, multicenter cohort study analyzed 12 170 patients admitted to 150 Spanish centers included in the SEMI-COVID-19 Network. We compared AS, defined as pulse pressure ≥60 mm Hg, and clinical characteristics between survivors and nonsurvivors. Mean age was 67.5 (±16.1) years and 42.5% were women. Overall, 2606 (21.4%) subjects died. Admission systolic blood pressure (BP) <120 and ≥140 mm Hg was a predictor of higher all-cause mortality (23.5% and 22.8%, respectively, P <0.001), compared with systolic BP between 120 and 140 mm Hg (18.6%). The 4379 patients with AS (36.0%) were older and had higher systolic and lower diastolic BP. Multivariate analysis showed that AS and systolic BP <120 mm Hg significantly and independently predicted all-cause in-hospital mortality (adjusted odds ratio [ORadj]: 1.27, P =0.0001; ORadj: 1.48, P =0.0001, respectively) after adjusting for sex (males, ORadj: 1.6, P =0.0001), age tertiles (second and third tertiles, ORadj: 2.0 and 4.7, P =0.0001), Charlson Comorbidity Index (second and third tertiles, ORadj: 4.8 and 8.6, P =0.0001), heart failure, and previous and in-hospital antihypertensive treatment. Our data show that AS and admission systolic BP <120 mm Hg had independent prognostic value for all-cause mortality in patients with COVID-19 requiring hospitalization.
Keywords: COVID-19; arterial stiffness; blood pressure; heart failure; hypertension; pulse pressure.
【저자키워드】 COVID-19, hypertension, heart failure, Arterial stiffness, blood pressure, pulse pressure., 【초록키워드】 coronavirus disease, Hospitalization, Clinical characteristics, Sex, risk factor, Patient, age, network, women, Admission, in-hospital mortality, Blood, association, Multivariate analysis, retrospective, Antihypertensive treatment, In-hospital, determinant, Systolic blood pressure, Prognostic value, Older, adjusted odds ratio, subject, nonsurvivors, Charlson Comorbidity Index, all-cause mortality, pulse, survivor, Spanish, males, independent, multicenter cohort study, diastolic, defined, predicted, analyzed, died, significantly, cardiovascular comorbidity, patients with COVID-19, 【제목키워드】 Impact, Spain, stiffness, arterial,