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Meta-Analysis
. 2023 Sep;13(3):495-503.
doi: 10.1007/s44197-023-00130-3. Epub 2023 Jun 15.

The Association of Hypertension with Increased Mortality Rate During the COVID-19 Pandemic: An Update with Meta-analysis

Ahmad R Al-Qudimat  1   2 , Ayisha Ameen  3 , Doaa M Sabir  3 , Heba Alkharraz  3 , Mai Elaarag  3 , Aisha Althani  3 , Kalpana Singh  4 , Wassim M Alhimoney  3 , Raed M Al-Zoubi  3   5   6 , Omar M Aboumarzouk  3   7   8
Affiliations
Meta-Analysis

The Association of Hypertension with Increased Mortality Rate During the COVID-19 Pandemic: An Update with Meta-analysis

Ahmad R Al-Qudimat et al. J Epidemiol Glob Health. 2023 Sep.

Abstract

Background and aim: The impact of multiple risk factors on COVID-19 mortality has been previously reported in multiple systematic reviews and meta-analyses. The aim of this review is to provide a comprehensive update on the association between hypertension (HTN) and mortality in patients with COVID-19.

Methods: A systematic review and meta-analysis were performed and followed the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. A search was achieved using PubMed, Scopus, and Cochrane Databases for research publications on hypertension, COVID-19, and mortality published between December 2019 and August 2022.

Results: A total of 23 observational studies involving 611,522 patients from 5 countries (China, Korea, the UK, Australia, and the USA) were included in our study. The confirmed number of COVID-19 with HTN cases in each study ranged from 5 to 9964. The mortality ranged from 0.17% to 31% in different studies. Pooled results show that the mortality rate of COVID-19 among the included studies ranges from a minimum of 0.39 (95% CI 0.13-1.12) to a maximum of 5.74 (95% CI 3.77-8.74). Out of the 611,522 patients, 3119 died which resulted in an overall mortality prevalence of 0.5%. Subgroup analyses indicated that patients with COVID-19 who have hypertension and male patients had slightly less risk of mortality than female patients [the percentage of men > 50%; OR 1.33: 95% CI (1.01, 1.76); the percentage of men ≤ 50%: OR 2.26; and 95% CI (1.15, 4.48)]. Meta-regression analysis results also showed a statistically significant association between hypertension and COVID-19 mortality.

Conclusion: This systematic review and meta-analysis suggest that hypertension may not be the only risk factor associated with the increased mortality rate during the COVID-19 pandemic. In addition, a combination of other comorbidities and old age appears to increase the risk of mortality from COVID-19. The impact of hypertension on mortality rate among COVID-19 patients.

Keywords: COVID-19; Chronic disease; HTN; Mortality; Pandemic; Prevalence.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

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The impact of hypertension on mortality rate among COVID-19 patients
Fig. 1
Fig. 1
Flow chart of included studies
Fig. 2
Fig. 2
Forest plot for the association between hypertension and mortality in patients with COVID-19
Fig. 3
Fig. 3
Random-effects meta-regression analysis of the effect of sex and countries on the association between hypertension with COVID-19 and mortality (A, B)
See this image and copyright information in PMC

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