Predictors of Severe and Critical COVID-19 in Hospitalized Hypertensive Patients

Introduction: The severe condition develops in every fifth patient with coronavirus disease 2019 (COVID-19). This study is aimed to assess the factors predicting severe and critical conditions in hypertensive patients with COVID-19-associated pneumonia. Materials and methods: A total of 106 unvaccinated hypertensive patients hospitalized for COVID-19-associated pneumonia were enrolled in the study. Results: Median body mass index (BMI) was higher in patients with severe/critical condition [30.4 (26.4-34.1) kg/m(2)] than in patients with moderate condition [25.3 (23.5-29.1) kg/m(2)] (p < 0.001). Diabetes mellitus was more prevalent in patients with severe/critical condition (40.7 vs 21.3%, p = 0.04). Erythrocyte sedimentation rate (ESR) was higher in patients with severe/critical condition [28.0 (14.0-34.5) vs 37.5 (24.0-46.5) mm/hour] (0.004). Patients who developed severe/critical condition were scored higher according to the community-acquired pneumonia symptom (CAP-Sym) questionnaire [30.0 (20.0-37.0) points] than patients who developed the moderate condition [22.0 (16.0-33.0) points] (p = 0.03). Also, ferritin level was higher in patients who developed severe/critical condition [430.5 (177.0-733.0) ng/mL] than in patients who developed the moderate condition [315.5 (169.0-396.0) ng/mL] (p = 0.03). BMI of =30 kg/m(2) increased the odds of severe/critical condition development [odds ratio (OR) = 3.83 (1.61-9.09), p = 0.002] and was the only independent predictor for the severe/critical condition according to the multivariate logistic regression analysis. Conclusion: Increased BMI, diabetes mellitus, high ESR, and ferritin level at admission predict severe/critical disease in unvaccinated hypertensive patients hospitalized for COVID-19. However, only BMI of =30 kg/m(2) is an independent risk factor for severe/critical disease according to multivariate logistic regression analysis. CAP-Sym questionnaire may be used for the prediction of severe/critical COVID-19.