Admission Systolic BP Helps Predict COVID-19 Hospitalization Outcomes

High systolic blood pressure at time of hospital admission can predict adverse outcomes in patients with COVID-19, according to a study in the American Journal of Hypertension.

In this retrospective, single-center study, researchers evaluated demographic, clinical, and laboratory admission data from 43 patients with COVID-19 admitted to a hospital in Wuhan City, China. The investigators also collected information on discharge or death, days from COVID-19 symptoms’ onset to admission, and days of hospitalization in this cohort.

Out of 157 patients with COVID-19 who were hospitalized at the hospital, 120 were ultimately discharged, and 37 patients died. A total of 43 parameters collected on day of admission were included in this study.

Hypertension and systolic blood pressure at time of admission correlated with severe COVID-19 as well as mortality and respiratory distress parameters, according to Pearson correlations. Systolic blood pressure was increased in patients who later died compared with patients who were discharged.

Using 13 admission parameters, a penalized logistic regression featuring a 5-fold cross-validation efficiently identified a model capable of predicting mortality in patients with COVID-19. A regularized Cox regression model efficiently predicted the probability of survival using only 7 of the 13 variables.

Systolic blood pressure, but not hypertension, represented a notable covariate in models predicting mortality and survival. Age, respiratory rate, and high-sensitivity C-reactive protein (hsCRP) were the overall 3 primary covariates predictive of COVID-19-related outcomes in these patients.

Limitations of this study include its retrospective nature and the small number of patients as well as the single-center design.

The investigators of this study noted that progress in the treatment of COVID-19 “is reducing case-fatality rates and may eventually supersede this particular model of risk prediction and necessitate development of new models adapted to a new reality.”

Reference

Caillon A, Zhao K, Klein KO, et al. High systolic blood pressure at hospital admission is an important risk factor in models predicting outcome of COVID-19 patients. Am J Hypertens. 2021;34(3):282-290. doi:10.1093/ajh/hpaa225