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Hypertension and Related Comorbidities as Potential Risk Factors for COVID-19 Hospitalization and Severity: A Prospective Population-Based Cohort Study.

ABSTRACT: The independent role of hypertension for COVID-19 outcomes in the population remains unclear. We aimed to estimate the independent effect of hypertension and hypertension-related conditions, i.e., cardiovascular, cerebrovascular and chronic kidney diseases, as potential risk factors for COVID-19 hospitalization and severe COVID-19 (i.e., intensive care unit admission or death) in the population. The risk for severe COVID-19 among hospitalized patients was also evaluated. A Spanish population-based cohort of people aged 25-79 years was prospectively followed from March to May 2020 to identify hospitalizations for laboratory-confirmed COVID-19. Poisson regression was used to estimate the adjusted relative risk (aRR) for COVID-19 hospitalization and severe COVID-19 among the whole cohort, and for severe COVID-19 among hospitalized patients. Of 424,784 people followed, 1106 were hospitalized by COVID-19 and 176 were severe cases. Hypertension was not independently associated with a higher risk of hospitalization (aRR 0.96, 95% CI 0.83-1.12) nor severe COVID-19 (aRR 1.12, 95% CI 0.80-1.56) in the population. Persons with cardiovascular, cerebrovascular and chronic kidney diseases were at higher risk for COVID-19 hospitalization (aRR 1.33, 95% CI 1.13-1.58; aRR 1.41, 95% CI 1.04-1.92; and aRR 1.52, 95% CI 1.21-1.91; respectively) and severe COVID-19 (aRR 1.61, 95% CI 1.13-2.30; aRR 1.91, 95% CI 1.13-3.25; and aRR 1.78, 95% CI 1.14-2.76; respectively). COVID-19 hospitalized patients with cerebrovascular diseases were at higher risk of mortality (aRR 1.80, 95% CI 1.00-3.23). The current study shows that, in the general population, persons with cardiovascular, cerebrovascular and chronic kidney diseases, but not those with hypertension only, should be considered as high-risk groups for COVID-19 hospitalization and severe COVID-19.

SUBMITTER: Fresan U

PROVIDER: S-EPMC8000595 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe incidence of cirrhosis for individuals in Sweden has previously been reported as stable/low among European countries. However, Swedish population-based studies are scarce and none of them included data from the most recent decade (2010-2019). We aimed to describe the incidence and aetiology of cirrhosis in the Halland region from 2011 to 2018, and to describe the severity and prevalence of liver-related complications and other primary comorbidities at the time of cirrhosis diagnosis.MethodsWe conducted a retrospective cohort study of all patients with cirrhosis in Halland, which has a population of 310,000 inhabitants. Medical records and histopathology registries were reviewed.ResultsA total of 598 patients with cirrhosis were identified. The age-standardised incidence was estimated at 23.2 per 100,000 person-years (95% CI 21.3-25.1), 30.5 (95% CI 27.5-33.8) for men and 16.4 (95% CI 14.3-18.7) for women. When stratified by age, the highest incidence rates were registered at age 60-69 years. Men had a higher incidence rate for most age groups when compared to women. The most common aetiology was alcohol (50.5%), followed by cryptogenic cirrhosis (14.5%), hepatitis C (13.4%), and non-alcoholic fatty liver disease (5.7%). Most patients had at least one liver-related complication at diagnosis (68%). The most common comorbidities at diagnosis were arterial hypertension (33%), type 2 diabetes (29%) and obesity (24%).ConclusionsBased on previous Swedish studies, our results indicate that the incidence of cirrhosis in Sweden might be considerably higher than previously reported. It is uncertain if the incidence of cirrhosis has previously been underestimated or if an actual increment has occurred during the course of the most recent decade. The increased incidence rates of cirrhosis reported in Halland are multifactorial and most likely related to higher incidence rates among the elderly. Pre-obesity and obesity are common in cirrhosis and non-alcoholic fatty liver disease has become an important cause of cirrhosis in Halland.

Project description:Study objectivesTo examine the relationship between functional health literacy (FHL) and obstructive sleep apnea (OSA), its diagnosis, related risk factors, and comorbidities.DesignPopulation cohort study.SettingAdelaide, South Australia, 2011-12.Participants1,021 Men Androgen Inflammation Lifestyle Environment and Stress Study participants aged ≥ 40 years, of whom 627 were identified with OSA by self-report (n = 184 previously diagnosed) or with in-home polysomnography in 837 randomly selected participants without self-reported OSA (n = 443 previously undiagnosed).InterventionsThe Newest Vital Sign assessed FHL in 88% of participants. Full in-home unattended polysomnography (Embletta X100) was scored by 2007 AASM (alternative) criteria.Measurements and resultsFHL was adequate in 75.3% (n = 122) of previously diagnosed and 68.3% (n = 261) of previously undiagnosed OSA. Not having a previous diagnosis was independently associated with inadequate FHL (odds ratio [OR]:2.84, 95% confidence interval [CI]:1.25-6.45) and workforce participation (OR = 2.04, 95% CI = 1.01-4.00), and inversely associated with previous snoring (OR = 0.48, 95% CI = 0.29-0.81), obesity (OR = 0.35, 95% CI = 0.15-0.81), and cardiovascular disease (OR = 0.45, 95% CI = 0.24-0.85). In polysomnography participants, inadequate FHL was independently associated with previously undiagnosed OSA (OR = 2.43, 95% CI = 1.40-4.20). In undiagnosed men, less than adequate FHL was independently associated with sedentary lifestyle (OR = 2.42, 95% CI = 1.36-4.29), and depression (OR = 2.50, 95% CI = 1.23-5.09) and inadequate FHL was associated with current smoking (OR = 2.87, 95% CI = 1.21-6.84). The depression association was attenuated after additional adjustment for comorbidities and general health (OR = 2.04, 95% CI = 0.93-4.49, P = 0.076). In previously diagnosed OSA, less than adequate FHL was independently associated with cardiovascular disease (OR = 2.76, 95% CI = 1.09-7.01).ConclusionsLimited functional health literacy was independently associated with obstructive sleep apnea (OSA), OSA diagnosis, lifestyle factors and comorbidities, highlighting the importance of developing and promoting national disease-specific health literacy policies.

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Hypertension and Related Comorbidities as Potential Risk Factors for COVID-19 Hospitalization and Severity: A Prospective Population-Based Cohort Study.

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