Objective 

A systematic analysis of concomitant arterial hypertension in COVID-19 patients and the impact of angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB’s) have not been studied in a large multicenter cohort. 

Aims We conducted a subanalysis from the international HOPE-Registry (https://hopeprojectmd.com, NCT04334291). Out of 5837 patients 2850 (48.8%) patients had the diagnosis arterial hypertension. 1978/2813 (70.3%) patients were already treated with ACEI or ARB’s. The clinical outcome of the present subanalysis included all-cause mortality during the first 40 days after admission. 

Results 

In the analyzed 2850 COVID-19 patients 25% were <65 years and 75%≥65 years. Among other cardiovascular risk factors dyslipidemia, diabetes mellitus and obesity were highly presented. 63.5% of patients had a history of cardiac disease and 24% pulmonary disease. At admission presenting symptoms were fever (74.9%), cough (66.7%), dyspnea (61.1%), fatigue (47.8%), tachypnoea (32.2%), arthromyalgia (28%) and diarrhea 19.6%. The death rate of this COVID-19 cohort with a concomitant arterial hypertension was 29.6% as compared with 11.3% without arterial hypertension (p<0.001). In the multivariate cox regression analysis, whereas age, benzodiazepine, antidepressant at admission, moderate Hyponatremia, respiratory insufficiency and invasive mechanical ventilation might be a negative independent predictors of mortality, antiviral drugs and interferon treatment might be an independent positive predictor of the mortality. 

Conclusions 

Although the mortality rate seems to be increased in patients suffering from arterial hypertension or treated with ACEI or ARB’s, both factors might not impact the outcome in the multivariate analysis.