Supplemental Digital Content is available in the text. Hypertension is one of the most common comorbidities in patients with coronavirus disease 2019 (COVID-19). This study aimed to clarify the impact of hypertension on COVID-19 and investigate whether the prior use of renin-angiotensin-aldosterone system (RAAS) inhibitors affects the prognosis of COVID-19. A total of 996 patients with COVID-19 were enrolled, including 282 patients with hypertension and 714 patients without hypertension. Propensity score-matched analysis (1:1 matching) was used to adjust the imbalanced baseline variables between the 2 groups. Patients with hypertension were further divided into the RAAS inhibitor group (n=41) and non-RAAS inhibitor group (n=241) according to their medication history. The results showed that COVID-19 patients with hypertension had more severe secondary infections, cardiac and renal dysfunction, and depletion of CD8+ cells on admission. Patients with hypertension were more likely to have comorbidities and complications and were more likely to be classified as critically ill than those without hypertension. Cox regression analysis revealed that hypertension (hazard ratio, 95% CI, unmatched cohort [1.80, 1.20–2.70]; matched cohort [2.24, 1.36–3.70]) was independently associated with all-cause mortality in patients with COVID-19. In addition, hypertensive patients with a history of RAAS inhibitor treatment had lower levels of C-reactive protein and higher levels of CD4+ cells. The mortality of patients in the RAAS inhibitor group (9.8% versus 26.1%) was significantly lower than that of patients in the non-RAAS inhibitor group. In conclusion, hypertension may be an independent risk factor for all-cause mortality in patients with COVID-19. Patients who previously used RAAS inhibitors may have a better prognosis.

中文翻译：

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COVID-19在原发性高血压患者中的临床特征以及肾素-血管紧张素-醛固酮系统抑制剂对COVID-19患者预后的影响

补充数字内容在文本中可用。高血压是 2019 年冠状病毒病 (COVID-19) 患者最常见的合并症之一。本研究旨在阐明高血压对 COVID-19 的影响，并调查先前使用肾素-血管紧张素-醛固酮系统 (RAAS) 抑制剂是否影响 COVID-19 的预后。共纳入 996 名 COVID-19 患者，其中高血压患者 282 例，非高血压患者 714 例。倾向得分匹配分析（1:1匹配）用于调整2组之间不平衡的基线变量。高血压患者根据用药史进一步分为RAAS抑制剂组（n=41）和非RAAS抑制剂组（n=241）。结果显示，患有高血压的 COVID-19 患者在入院时有更严重的继发感染、心肾功能障碍以及 CD8+ 细胞耗竭。与没有高血压的患者相比，高血压患者更可能出现合并症和并发症，并且更可能被归类为重症。Cox 回归分析显示，高血压（风险比，95% CI，未匹配队列 [1.80, 1.20–2.70]；匹配队列 [2.24, 1.36–3.70]）与 COVID-19 患者的全因死亡率独立相关。此外，有 RAAS 抑制剂治疗史的高血压患者的 C 反应蛋白水平较低，CD4+ 细胞水平较高。RAAS 抑制剂组患者的死亡率（9.8% 对 26. 1%) 显着低于非 RAAS 抑制剂组患者。总之，高血压可能是 COVID-19 患者全因死亡的独立危险因素。以前使用过 RAAS 抑制剂的患者可能有更好的预后。