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COVID-19 Outcomes Stratified by Control Status of Hypertension and Diabetes: Preliminary Findings From PCORnet, U.S.
Jackson, Sandra L. Block, Jason P. Rolka, Deborah B. Pavkov, Meda E. Chevinsky, Jennifer R. Lekiachvili, Akaki Carton, Thomas W. Thacker, Deepika Denson, Joshua L.
Jackson, Sandra L.
Block, Jason P.
Rolka, Deborah B.
Pavkov, Meda E.
Chevinsky, Jennifer R.
Lekiachvili, Akaki
Carton, Thomas W.
Thacker, Deepika
Denson, Joshua L.
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Journal article
Date
2022-08-09
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Medicine
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http://dx.doi.org/10.1016/j.focus.2022.100012
Abstract
Introduction: Hypertension and diabetes are associated with increased COVID-19 severity, yet less is known about COVID-19 outcomes across levels of disease control for these conditions. Methods: All adults aged ≥20 years with COVID-19 between March 1, 2020 and March 15, 2021 in 42 healthcare systems in National Patient-Centered Clinical Research Network were identified. Results: Among 656,049 adults with COVID-19, 41% had hypertension, and 13% had diabetes. Of patients with classifiable hypertension, 35% had blood pressure <130/80 mmHg, 40% had blood pressure of 130‒139/80‒89 mmHg, 21% had blood pressure of 140‒159/90‒99 mmHg, and 6% had blood pressure ≥160/100 mmHg. Severe COVID-19 outcomes were more prevalent among those with blood pressure of ≥160/100 than among those with blood pressure of 130–139/80–89, including hospitalization (23.7% [95% CI=23.0, 24.4] vs 11.7% [95% CI=11.5, 11.9]), receipt of critical care (5.5% [95% CI=5.0, 5.8] vs 2.4% [95% CI=2.3, 2.5]), receipt of mechanical ventilation (3.0% [95% CI=2.7, 3.3] vs 1.2% [95% CI=1.1, 1.3]), and 60-day mortality (4.6% [95% CI=4.2, 4.9] vs 1.8% [95% CI=1.7, 1.9]). Of patients with classifiable diabetes, 44% had HbA1c <7%, 35% had HbA1c 7% to <9%, and 21% had HbA1c ≥9%. Hospitalization prevalence was 31.3% (95% CI=30.7, 31.9) among those with HbA1c <7% vs 40.2% (95% CI=39.4, 41.1) among those with HbA1c ≥9%; other outcomes did not differ substantially by HbA1c. Conclusions: These findings highlight the importance of appropriate management of hypertension and diabetes, including during public health emergencies such as the COVID-19 pandemic.
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Citation
Sandra L. Jackson, Jason P. Block, Deborah B. Rolka, Meda E. Pavkov, Jennifer R. Chevinsky, Akaki Lekiachvili, Thomas W. Carton, Deepika Thacker, Joshua L. Denson, Anuradha Paranjape, Michael D. Kappelman, Tegan K. Boehmer, Evelyn Twentyman, COVID-19 Outcomes Stratified by Control Status of Hypertension and Diabetes: Preliminary Findings From PCORnet, U.S., AJPM Focus, Volume 1, Issue 1, 2022, 100012, ISSN 2773-0654, https://doi.org/10.1016/j.focus.2022.100012.
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Elsevier
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AJPM Focus, Vol. 1, Iss. 1
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