A MODEL FOR PREDICTING COVID-19 OUTCOMES IN INDIVIDUALS WITH ARTERIAL HYPERTENSION
Authors/Creators
- 1. Medical Institute of the North-Eastern Federal University named after M.K. Ammosov, Yakutsk, Russia
- 2. Yakutsk Scientific Centre of Complex Medical Problems, Yakutsk, Russia
- 3. FRCC MRCS FMBA Russia, Moscow, Russia
- 4. Russian Center of Neurology, Moscow, Russia
Description
The aim of the work: to develop a predictive model for fatal outcomes of COVID-19 in hospitalized patients with arterial hypertension. Material and methods. A retrospective analysis was conducted using 200 medical records of patients with a confirmed diagnosis of COVID-19 and concomitant arterial hypertension who received inpatient treatment at the Yakut Republican Clinical Hospital (Yakutsk) between 2020 and 2022. Based on outcomes, patients were divided into two groups: Group 1 included 150 (75%) patients discharged with improvement, and Group 2 included 50 (25%) patients with a fatal outcome. To analyze the association of risk factors with adverse outcomes of COVID-19, binary logistic regression was performed using StatTech software v.4.8.11. To compare the two groups, the Student’s t-test or the Mann-Whitney U-test were used, depending on the distribution. Categorical data was expressed in absolute values and percentages. The effect was assessed using the odds ratio with a 95% confidence interval. The predictive model was built using logistic regression, the Nigelkirk coefficient R2 and ROC curves. The cut-off value was determined by the maximum of the Juden index. Results. Multivariate analysis of 200 parameters from patients with COVID-19 and hypertension identified four predictors associated with fatal outcome: age (p < 0,011), SpO2 (p = 0,001), BNP levels (p = 0,003), and C-reactive protein levels (p = 0,020). The developed model was evaluated using the area under the ROC curve (AUC = 79,8%) and demonstrated high sensitivity (72,0%) and specificity (85,3%). Conclusion. Predictors of increased risk for adverse outcomes of coronavirus infection in patients with arterial hypertension included age, BNP and C-reactive protein concentrations, and oxygen saturation (SpO2) at admission. A predictive model for assessing the risk of adverse outcomes of COVID-19 in hospitalized patients with hypertension was developed, demonstrating high specificity and significant practical value.
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References
- 1. Kudryavtseva N. A., Chorbinskaya S. A., Devyatkin A. V., et al. Features of the course of COVID-19 infection in a multidisciplinary hospital. Kremlin Medicine. Clinical Bulletin. 2023;1:25-32. (In Russ.). doi:10.48612/cgma/bfu5-humt-m6dv.
- 2. Podzolkov V. I., Bragina A. E., Tarzimanova A. I., et al. Arterial Hypertension and Severe COVID-19 in Hospitalized Patients: Data from a Cohort Study. Rational Pharmacotherapy in Cardiology 2023;19(1):4-10. (In Russ.). doi:10.20996/1819-6446-2023-01-10.
- 3. Korostovtseva L. S., Rotar O. P., Konradi A. O. COVID 19: what are the risks in hypertensive patients? Arterial Hypertension. 2020;26(2):124-132. (In Russ.). doi:10.18705/1607419X-2020-26-2-124-132.
- 4. Balanova Yu. A., Shalnova S. A., Kutsenko V. A., et al. Contribution of hypertension and other risk factors to survival and mortality in the Russian population. Cardiovascular Therapy and Prevention. 2021;20(5):3003. (In Russ.). doi:10.15829/17288800-2021-30035.
- 5. Ahmad R. A., Ameen А., Doaa M S., Alkharraz H., et al. The Association of Hypertension with Increased Mortality Rate During the COVID-19 Pandemic: An Update with Meta-analysis. J Epidemiol Glob Health. 2023;13(3): 495-503. doi:10.1007/s44197-023-00130-3.
- 6. Sadykova D. I., Khaliullina S. V., Anokhin V. A., et al. Clinical manifestations of new coronavirus infection (COVID-19) in children admitted to hospital. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2021;66(5):88-96. (In Russ.). doi:10.21508/10274065-2021-66-5-88-96.
- 7. Bani Hani S., Ahmad M. Effective Prediction of Mortality by Heart Disease Among Women in Jordan Using the Chi-Squared Automatic Interaction Detection Model: Retrospective Validation Study. JMIR Cardio. 2023;7:e48795. doi:10.2196/48795.
- 8. Karyakin N. N., Saperkin N. V., Bavrina A. P., et al. Modernization of regression models to predict the number of deaths from the new coronavirus infection. Sovremennye tehnologii v medicine 2020;12(4):6-12. (In Russ.). doi:10.17691/ stm2020.12.4.01.
- 9. Ilina N. А., Sleptsova S. S., Diachkovskaia P. S., et al. Predictors of the severity of the course of the new coronavirus infection covid-19 in the republic of sakha (Yakutia). Modern problems of science and education. 2022;2. URL: https://scienceeducation.ru/ru/article/view?id=31631. (In Russ.). doi:10.17513/spno.31631.
- 10. Docherty A. B., Harrison E. M., Green C. A., et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: Prospective observational cohort study. The BMJ. 2020;369 (3):1-12. doi:10.1136/bmj.m1985.
- 11. Izcovich А., Ragusa M.A., Tortosa F., et al. Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review. PLoS ONE. 2020;15(11):1-30. doi:10.1371/ journal.pone.0241955.
- 12. Dessie Z. G., Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infectious Diseases. 2021;21(1):855. doi:10.1186/s12879-021-06536-3.
- 13. Mejía F., Medina С., Cornejo Е., et al. Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru. PLoS ONE. 2020;15. (12):1-12. doi:10.1371/journal.pone.0244171.
- 14. Tarlovskaya E. I., Arutyunov A. G., Konradi A. O., et al. Analysis of influence of background therapy for comorbidities in the period before infection on the risk of the lethal COVID outcome. Data from the international ACTIV SARS-CoV-2 registry («Analysis of chronic non-infectious diseases dynamics after COVID-19 infection in adult patients SARS-CoV-2»). Kardiologiia. 2021;61(9):20-32. (In Russ.). doi:10.18087/cardio.2021.9.n1680.
- 15. Villoteau А., Asfar М., Otekpo М., et al. Elevated C-reactive protein in early COVID-19 predicts worse survival among hospitalized geriatric patients. PLoS ONE. 2021;16 (9):1-9. doi:10.1371/ journal.pone.0256931.
- 16. Arsenteva E. V., Chugunova A. V., Dzhuganova V. O. Brain natriuretic peptide in diagnosis of heart failure in patients with new coronavirus infection (COVID-19). Bashkortostan Medical Journal. 2020;15(5):98-101. (In Russ.).
- 17. Prevention, diagnosis and treatment of the new coronavirus infection (COVID–19): temporary guidelines of the Ministry of Health of the Russian Federation "Version 12 of September 12, 2021". Moscow. 2021. https://static-0.minzdrav.gov.ru/ system/attachments/attaches/000/058/075/ original/ ВМР_COVID-19_V12.pdf.