COVID-19 Outcomes Stratified by Control Status of Hypertension and Diabetes: Preliminary Findings From PCORnet, U.S

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  • Jackson, Sandra L.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Block, Jason P.
    • Other Affiliation: Harvard Medical School
  • Rolka, Deborah B.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Pavkov, Meda E.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Chevinsky, Jennifer R.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Lekiachvili, Akaki
    • Other Affiliation: Centers for Disease Control and Prevention
  • Carton, Thomas W.
    • Other Affiliation: Louisiana Public Health Institute
  • Thacker, Deepika
    • Other Affiliation: Nemours Children’s Health
  • Denson, Joshua L.
    • Other Affiliation: Tulane University School of Medicine
  • Paranjape, Anuradha
    • Other Affiliation: Temple University
  • Kappelman, Michael D.
    • Affiliation: School of Medicine, Department of Pediatrics
  • Boehmer, Tegan K.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Twentyman, Evelyn
    • Other Affiliation: Centers for Disease Control and Prevention
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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  • Article
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  • Attribution 4.0 International
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  • AJPM focus
Journal volume
  • 1
Journal issue
  • 1
Page start
  • 100012
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  • English
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  • 2773-0654

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