AIMS: As reported, hypertension may play an important role in adverse outcomes of coronavirus disease-2019 (COVID-19), but it still had many confounding factors. The aim of this study was to explore whether hypertension is an independent risk factor for critical COVID-19 and mortality. DATA SYNTHESIS: The Medline, PubMed, Embase, and Web of Science databases were systematically searched until November 2020. Combined odds ratios (ORs) with their 95% confidence interval (CIs) were calculated by using random-effect models, and the effect of covariates was analyzed using the subgroup analysis and meta-regression analysis. A total of 24 observational studies with 99,918 COVID-19 patients were included in the meta-analysis. The proportions of hypertension in critical COVID-19 were 37% (95% CI: 0.27 -0.47) when compared with 18% (95% CI: 0.14 -0.23) of noncritical COVID-19 patients, in those who died were 46% (95%CI: 0.37 -0.55) when compared with 22% (95% CI: 0.16 -0.28) of survivors. Pooled results based on the adjusted OR showed that patients with hypertension had a 1.82-fold higher risk for critical COVID-19 (aOR: 1.82; 95% CI: 1.19 - 2.77; P = 0.005) and a 2.17-fold higher risk for COVID-19 mortality (aOR: 2.17; 95% CI: 1.67 - 2.82; P  60 years was associated with a significantly increased risk of COVID-19 mortality (OR: 3.12; 95% CI: 1.93 - 5.05; P < 0.001). Meta-regression analysis results also showed that age (Coef. = 2.3×10-2, P = 0.048) had a significant influence on the association between hypertension and COVID-19 mortality. CONCLUSIONS: Evidence from this meta-analysis suggested that hypertension was independently associated with a significantly increased risk of critical COVID-19 and inhospital mortality of COVID-19.

Hypertension is a clinically important risk factor for critical illness and mortality in COVID-19: A meta-analysis.

Background The recent outbreak of COVID-19 has rapidly spread worldwide. A large proportion of COVID-19 patients with chronic underlying complications have been reported to be in severe condition and show unpromising clinical outcomes. But whether chronic comorbidities are risk factors affecting the severity of COVID-19 has not been well described.
Methods
 We included COVID-19 patients who had been admitted to Tongji Hospital, Tongji medical college of HUST (Wuhan, China) from January, 27, 2020 to March, 8, 2020 in this retrospective cohort study. The final date of follow-up was March, 30, 2020. All patients were diagnosed with COVID-19 according to Prevention and control Scheme for Novel Coronavirus Pneumonia published by National Health Commission of the People9 s Republic of China and WHO interim. Demographic data, medical history, clinical symptoms and signs, laboratory findings, chest computed tomography (CT), treatment and clinical outcomes were extracted from electronic medical records with standardized data collection forms and compared among different groups.
Results
 1031 COVID-19 inpatients were included in this study, of whom 866 were discharged and 165 were dead in hospital. 73% of 165 dead patients had complicated chronic comorbidities. Of the 1031 patients, 514 (50%) were combined with chronic comorbidities, and showed CFR 2.8 times as that of patients without any underlying disease. 
The number of patients with hypertension accounted for three fourths of those with concomitant underlying diseases. The univariable regression revealed that patients in the simple hypertension group showed overall risk higher than those in the simple diabetes mellitus group. In the age-grouped research, patients in the hypertension senile group were proved to be at the highest risk, which might be associated with the level of LDH and eGFR. In this retrospective cohort study, 166 (43%) patients with hypertension took CCB during the hospitalization, the odds ratio of CFR in patients with hypertension taking CCB group was 0.68 (P = 0.155), compared to those not.
Conclusion
 Our data shows that the clinical manifestations of most hospitalized patients with COVID-19 are actually systemic syndromes, although COVID-19 is defined as novel coronavirus pneumonia in China. Hypertension is not just a chronic underlying comorbidity, but also a risk factor affecting the severity of COVID-19 and does play a critical role in improving patients9 clinical outcomes. Therefore, hypertension management in patients with COVID-19 should be a major challenge in the diagnostic and therapeutic strategies, including optimal management of blood pressure and pathophysiological status.

/pdf/impact-of-chronic-comorbidities-on-progression-and-prognosis-55fk5l0ff4.pdf

Impact of Chronic Comorbidities on Progression and Prognosis in Patients with COVID-19: A Retrospective Cohort Study in 1031 Hospitalized Cases in Wuhan, China

Anita Andreano Epidemiology Unit, Agency for Health Protection of Milan Rossella Murtas Agency for Health Protection of Milan Sara Tunesi Agency for Health Protection of Milan Maria Teresa Greco Agency for Health Protection of Milan David Consolazio Agency for Health Protection of Milan Davide Guido Agency for Health Protection of Milan Federico Gervasi Agency for Health Protection of Milan Maria Elena Gattoni Agency for Health Protection of Milan Monica Sandrini Agency for Health Protection of Milan Antonio Riussi Agency for Health Protection of Milan Antonio Giampiero Russo (  agrusso@ats-milano.it ) Agency for Health Protection of Milan

/pdf/development-of-a-multivariable-model-predicting-covid-19-4dw888tb85.pdf

Development of a multivariable model predicting COVID-19 mortality risk from comorbidities in an Italian cohort of 18,286 confirmed cases aged 40 years or older

Abstract Background: Coronavirus disease 2019 (COVID-19) has various sequelae, one of which might be hypertension. We aimed to evaluate COVID-19’s impact on blood pressure (BP) in non-hospitalized patients at one-year follow-up. Method: A total of 7,950 consecutive COVID-19 patients regularly visiting our cardiology clinic were retrospectively screened. Patients' electronic medical records including demographics, comorbidities, vital signs, treatments, and outcomes, were reviewed by two physicians. Individuals with at least one BP measurement in the three months preceding COVID-19 and one measurement in 12 months or more following recovery were included. BP levels before and after COVID-19 were compared using the paired t-test. Results : 5,355 confirmed COVID-19 patients (mean age 55.51 ± 15.38 years) were included. Hypertension (56.9%) and diabetes mellitus (34%) were the predominant comorbidities, and 44.3% had prior major adverse cardiovascular events. Both systolic (126.90 ± 20.91 vs. 139.99 ± 23.94 mmHg, P&lt;0.001) and diastolic BP (80.54 ± 13.94 vs. 86.49 ± 14.40 mmHg, P&lt;0.001) were significantly higher post-COVID-19 vs. pre-COVID-19. Notably, 456 (14%) hypertensive patients experienced exacerbated hypertension, while 408 (17%) patients developed new-onset hypertension, overall 864 (16%) of patients had exacerbation or new hypertension. Linear regression analysis revealed that advanced age, smoking, previous cardiovascular events, hypertension, and diabetes mellitus predict increased BP following COVID-19 (P &lt;0.001). Conclusion: COVID-19 raised systolic and diastolic BP in the long term in non-hospitalized patients, with over one-sixth developing new-onset or exacerbated hypertension. All patients should be evaluated regarding BP, following COVID-19 recovery, particularly those with the mentioned predictive factors. (clinicaltrial.gov: NCT05798208) 

Evaluation of blood pressure variation in recovered COVID-19 patients at one-year follow-up: a retrospective cohort study

Coronavirus disease 2019 (COVID-19) has various sequelae, one of which might be hypertension. We aimed to evaluate COVID-19's impact on blood pressure (BP) in non-hospitalized patients at one-year follow-up. 


 Background: The recent outbreak of SARS-CoV-2 infection results in a considerable morbidity and mortality, mainly in China. The study is to investigate the intrinstic features of infected patients that associated with severe type of this disease. Method: A total of 487 laboratory-confirmed COVID-19 patients were included in analysis. The demographic and epidemiological of patients representing as mild and severe at admission were compared. A step-wise multivariate logistic regression analysis were performed to identify significant risk factors associated with severe COVID-19 . A score systemc incorporating risk factors was established for risk stratification and validated in a small cohort during in-hospital follow-up. Results: Of all patients, 49 (10.1%) cases are severe at admission. Severe cases are elder [56(17) vs. 45(19), P<0.001), with more male (73.5% vs. 50.9%, P=0.003). They have a higher incidence of hypertension (53.1% vs. 16.7%, P<0.001), diabetes (14.3% vs. 5.0%, P=0.009), cardiovascular diseases (8.2% vs. 1.6%, P=0.003) and malignancy (4.1% vs. 0.7%, P=0.025), and less exposure to epidemic area (49.0% vs. 65.1%, P=0.027), but more infected familiy members(P=0.031). On multivariate analysis, elder age, male and presence of hypertension are independently associated with severe disease at admission. A host risk score, incorporating age, sex and hypertension history, clearly stratifies risk of developing severe type of COVID-19 both in patients at admission and during in-hospital follow-up. Conclusions: Elder age, male and presence of hypertension are associated with host susceptibility to developing severe COVID-19. The host risk score may be a useful tool to identify high risk indiviuals but requires validation.

/pdf/host-susceptibility-to-severe-covid-19-a-retrospective-2bct2crrnx.pdf

Host susceptibility to severe COVID-19: a retrospective analysis of 487 case outside Wuhan

Esophageal cancer (EC) is one of the most common digestive system malignancies in the world. The combined modality treatment of EC is usually surgery and radiation therapy, however, its clinical efficacy for advanced patients is relatively limited. Ferroptosis, a new type of iron-dependent programmed cell death, is different from apoptosis, necrosis and autophagy. In recent years, many studies have further enlightened that ferroptosis plays an essential role in the occurrence, development and metastasis of tumors. Targeting ferroptosis stimulates a new direction for further exploration of oncologic treatment regimens. Furthermore, ferroptosis has a critical role in the immune microenvironment of tumors. This paper reviews the mechanism of ferroptosis and the ferroptosis research progress in the treatment of EC. We further elaborate the interaction between ferroptosis and immunotherapy, and the related mechanisms of ferroptosis participation in the immunotherapy of EC, so as to provide new directions and ideas for the treatment of EC.

Treatment of Candida albicans liver abscess complicated with COVID-19 after liver metastasis ablation: A case report

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Host susceptibility to severe COVID-19: a retrospective analysis of 487 case outside Wuhan

Treatment of Candida albicans liver abscess complicated with COVID-19 after liver metastasis ablation: A case report