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Objective <p>To identify clinical factors independently associated with COVID-19–related hospitalization and short-term mortality among hypertensive patients managed in Primary Care in Spain.</p> Methods <p>Multicenter retrospective cohort study including 1,372 hypertensive adults (≥ 18&#xa0;years) with PCR-confirmed SARS-CoV-2 infection between May 2021 and February 2022. Multivariable logistic regression models adjusted for predefined confounders (age, sex, smoking status, and obesity) were used to evaluate factors independently associated with hospital admission and 3-month all-cause mortality.</p> Results <p>Hospital admission occurred in 29.2% of patients, ICU admission in 5.0%, and 3-month mortality was 4.0%. Chronic kidney disease (aOR 1.52; 95% CI 1.08–2.14), heart failure (aOR 2.55; 95% CI 1.74–3.74), atrial fibrillation (aOR 2.16; 95% CI 1.50–3.12), diabetes in patients aged &lt; 60&#xa0;years (aOR 2.54; 95% CI 1.41–4.60), peripheral arterial disease (aOR 2.17; 95% CI 1.31–3.58), chronic obstructive pulmonary disease (aOR 1.83; 95% CI 1.33–2.51), and immunocompromised status (aOR 3.19; 95% CI 1.89–5.53) were independently associated with hospital admission. A significant interaction between smoking and chronic kidney disease was observed (aOR 6.80; 95% CI 2.37–19.48). RAAS inhibitor use was not associated with hospitalization.</p> <p>For mortality, chronic kidney disease (aOR 4.34; 95% CI 2.37–7.94), atrial fibrillation (aOR 4.09; 95% CI 2.18–7.68), heart failure (aOR 3.66; 95% CI 1.91–7.02), chronic obstructive pulmonary disease (aOR 2.95; 95% CI 1.59–5.47), and peripheral arterial disease (aOR 2.05; 95% CI 1.21–3.47) were independently associated with death. Estimates for mortality should be interpreted in light of the limited number of events.</p> Conclusions <p>In hypertensive patients with COVID-19 managed in Primary Care, cardiovascular and renal comorbidities were independently associated with hospitalization and short-term mortality. Chronic kidney disease and heart failure showed the strongest and most consistent associations across outcomes. RAAS inhibitor use was not associated with increased risk.</p>

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Clinical factors associated with hospitalization and mortality from COVID-19 in hypertensive patients in primary care: a multicenter study in Spain

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  • 发表日期：

    2026年3月16日

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  • José Abellán Alemán,
  • Alcibíades Segundo Díaz Vera,
  • Maravillas Sánchez Macarro,
  • Francisco Valls Roca,
  • Francisco J. Fuentes Jiménez,
  • Fernando García Romanos,
  • Manuel A. Gómez Marcos,
  • Jesús Iturralde Iriso,
  • Rafael Crespo Sabarís,
  • Ángeles Velasco Soria,
  • Javier Sobrino Martínez,
  • Javier Nieto Iglesias,
  • Laura Martín Piedra,
  • Esperanza Sastre Menor,
  • Alejandro Serrán Jiménez,
  • Alberto Díaz Cáceres,
  • Mª del Mar Manchado Reinoso,
  • Susana Martínez Palli,
  • Ana Moyà Amengual,
  • Esther Pozuelo,
  • Juan Fernando Peiró Morant,
  • Elena González Garrido,
  • María Isabel Orlandis Vázquez,
  • Irene Mestres Maza,
  • Esperanza Moral Berrio,
  • Gloria García Conejo,
  • Guillermo Ferrer García,
  • Lorena González Rodríguez,
  • Lorena Herráez García,
  • Paz Castro Fernández,
  • Roger Abdúvar Cox Conforme,
  • Pedro Juan Tárraga López,
  • Javier Alonso Moreno,
  • Cristina Rojas de Teresa,
  • He Zhang Lin,
  • Gregorio Mediavilla Tris,
  • Mariluz Alarcia Ceballos,
  • Margarita Pinel Monge,
  • José Manuel Calleja Pascual,
  • José Manuel Calleja Pascual,
  • Mar López Miralles,
  • Carmen Zarate Oñate,
  • Ekiñe Zorrilla Amirola,
  • Miren Arrazola Vallejo,
  • Maialen Ormazábal Iñiguez de Heredia,
  • Raúl Lapeña Gómez,
  • Danele Barandiarán Abaroa,
  • Javier Guinea Castañares,
  • María del Carmen Latorre Aliaga,
  • Francisco Javier González García,
  • Ana Isabel Bas,
  • José Basilio Gómez Castaño,
  • Francisca Díaz Ortega,
  • Inmaculada Torres Fernández,
  • Luisa Mª Fernández Rodríguez,
  • Isabela Borrajo Brunete,
  • Inmaculada López Carrillo,
  • Carmen Martínez Sanz,
  • Sara García Saorín,
  • Ana Fátima Navarro Oliver,
  • Ainara Bayle Mayor,
  • Marina Sánchez Solano,
  • Fernando Hernández Menárguez,
  • Antonio Martínez Pastor,
  • Josefa Sánchez Sánchez,
  • María José Gómez González,
  • María Isabel González Sánchez,
  • Ángela Boloufer Pérez,
  • Fátima María Ballesta Selma,
  • Purificación Gómez Jara,
  • Domingo José Rubira López,
  • Pedro Javier Martínez Sánchez,
  • Fátima López Valls,
  • Juan Francisco Martínez García,
  • Lidia Ruiz Albaladejo,
  • Francisco Manuel Lafuente Salanova,
  • Ramón López Guillén,
  • Elena Pascual Roquet-Jalmar,
  • M. Pilar Martín Sánchez,
  • Beatriz Claudia Arostegui Castillo de la Flor,
  • Arantzazu Igoa Erro,
  • Mohamed Hamdi Djatri,
  • Quintín Campistegui Ramírez,
  • Laura Caro Pérez,
  • Fernando José Juárez Bonilla,
  • Manuel Angel Gómez Marcos,
  • Luis García Ortiz,
  • Olaya Tamayo Morales,
  • Cristina Lugones Sánchez,
  • Susana González Sánchez,
  • Benigna Sánchez Salgado,
  • Laura Montero García,
  • Alba Alegre Fernández,
  • María Pilar Torres Rodríguez,
  • María José Recio Calzada,
  • Ana Isabel Alonso Ruiz,
  • Juan Lobato Carrasco,
  • Marta Román Garrido,
  • Nuria Porto Millara,
  • Aarón Hernández Sánchez,
  • Clara Isabel Soria López,
  • Karen Ruth Barroso López,
  • Ana García-Puente García,
  • Paz Muriel Díaz,
  • Saray Porras Sáez,
  • José Antonio Gómez Miguel,
  • Nuria Suárez Moreno,
  • Lydia María Pérez Carbayo,
  • Inés Marcos Romero,
  • Isabel Moreno Sánchez,
  • Manuel Mejías Gil,
  • María Rocío Cubino Luis,
  • María Luisa Moro Mateos,
  • Alberto Vicente Prieto,
  • María Isabel Ruiz Martínez,
  • M Auxiliadora Velasco Ramos,
  • Jesús Martín González,
  • Francisca Castaño Pérez,
  • Cristina Muñoz Martín,
  • Lourdes Montejo Perrino,
  • Mónica García San José,
  • Raquel Carpio Marcos,
  • Joaquín Timón Olea,
  • Susana Garrote Pascual,
  • Carolina Domínguez Acosta,
  • Alejandro Domínguez Bejarano,
  • Emiliano Rodríguez Sánchez,
  • Nicolás Morel Alba,
  • Alberto Romero Galán,
  • Irene Lluch Verdú,
  • Yuniel Valerón Menéndez

摘要

Objective

To identify clinical factors independently associated with COVID-19–related hospitalization and short-term mortality among hypertensive patients managed in Primary Care in Spain.

Methods

Multicenter retrospective cohort study including 1,372 hypertensive adults (≥ 18 years) with PCR-confirmed SARS-CoV-2 infection between May 2021 and February 2022. Multivariable logistic regression models adjusted for predefined confounders (age, sex, smoking status, and obesity) were used to evaluate factors independently associated with hospital admission and 3-month all-cause mortality.

Results

Hospital admission occurred in 29.2% of patients, ICU admission in 5.0%, and 3-month mortality was 4.0%. Chronic kidney disease (aOR 1.52; 95% CI 1.08–2.14), heart failure (aOR 2.55; 95% CI 1.74–3.74), atrial fibrillation (aOR 2.16; 95% CI 1.50–3.12), diabetes in patients aged < 60 years (aOR 2.54; 95% CI 1.41–4.60), peripheral arterial disease (aOR 2.17; 95% CI 1.31–3.58), chronic obstructive pulmonary disease (aOR 1.83; 95% CI 1.33–2.51), and immunocompromised status (aOR 3.19; 95% CI 1.89–5.53) were independently associated with hospital admission. A significant interaction between smoking and chronic kidney disease was observed (aOR 6.80; 95% CI 2.37–19.48). RAAS inhibitor use was not associated with hospitalization.

For mortality, chronic kidney disease (aOR 4.34; 95% CI 2.37–7.94), atrial fibrillation (aOR 4.09; 95% CI 2.18–7.68), heart failure (aOR 3.66; 95% CI 1.91–7.02), chronic obstructive pulmonary disease (aOR 2.95; 95% CI 1.59–5.47), and peripheral arterial disease (aOR 2.05; 95% CI 1.21–3.47) were independently associated with death. Estimates for mortality should be interpreted in light of the limited number of events.

Conclusions

In hypertensive patients with COVID-19 managed in Primary Care, cardiovascular and renal comorbidities were independently associated with hospitalization and short-term mortality. Chronic kidney disease and heart failure showed the strongest and most consistent associations across outcomes. RAAS inhibitor use was not associated with increased risk.