Factors Affecting Mortality in Elderly Hypertensive Hospitalized Patients with COVID-19: A Retrospective Study

Xu et al., Clinical Interventions in Aging, doi:10.2147/cia.s431271

Nov 2023

Retrospective 748 elderly hospitalized COVID-19 patients in China showing increased risk of death with paxlovid/molnupiravir. Multivariate analysis showed that paxlovid/molnupiravir was independently associated with higher in-hospital mortality (HR 3.3, p=0.006). Authors do not provide results for paxlovid and molnupiravir separately.

Concerns have been raised that the mutagenic mechanism of action may create dangerous variants or cause cancer Chamod, Gruber, Hadj Hassine, Huntsman, Marikawa, Swanstrom, Waters, Zhou, Zibat. Multiple analyses have identified variants potentially created by molnupiravir Fountain-Jones, Kosakovsky Pond, Sanderson, twitter.com.

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Important missing comments or errors? Let us know.

Study covers paxlovid and molnupiravir.

risk of death, 232.2% higher, HR 3.32, p = 0.006, treatment 68, control 680, adjusted per study, multivariable, Cox proportional hazards.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Xu et al., 30 Nov 2023, retrospective, China, peer-reviewed, median age 76.0, 3 authors, study period 8 December, 2022 - 7 January, 2023. Contact: lily197459@163.com.

This Paper Molnupiravir All

Factors Affecting Mortality in Elderly Hypertensive Hospitalized Patients with COVID-19: A Retrospective Study

Qun Xu, Fangzhou Li, Xujiao Chen

Clinical Interventions in Aging, doi:10.2147/cia.s431271

Purpose: Corona Virus Disease 2019 (COVID-19) endangers the health and survival of the elderly. We tried to explore factors especially kidney function which affected mortality in elderly hypertensive patients with COVID-19. Methods: We conducted a retrospective research of 748 COVID-19 elderly patients (≥65 years old) at Zhejiang Hospital. This study compared demographic data, laboratory values, comorbidities, treatments, and clinical outcomes of hypertension and non-hypertension participants, and subgroup analysis of age and frailty was conducted in the hypertension population. Survival analysis was used to determine risk factors for death in elderly patients with COVID-19. Results: Our study revealed that the elderly hypertensive patients with COVID-19 had higher blood urea nitrogen (BUN), serum uric acid (UA), serum creatinine (Scr), lower estimated glomerular filtration rate (eGFR), higher incidence of severity, admission to intensive care unit (ICU) and death, and longer in-hospital stay than non-hypertensive patients, which also occurred in the very elderly hypertensive patients compared with younger hypertensive patients and frail hypertensive patients compared with no-frail hypertensive patients. In addition, the prevalence of acute kidney injury (AKI) was higher in the oldest old hypertensive patients and frail hypertensive patients. Multivariate survival analysis indicated that the independent risk factors for death from COVID-19 were age ≥80 years, heart failure, antiviral therapy, calcium channel blocker (CCB) therapy, mechanical ventilation, AKI, and eGFR<60 mL/min per 1.73 m 2 . Conclusion: The results of the present study suggested that the elderly hypertensive patients with COVID-19 would have more serious kidney injury, more serious disease progression and higher mortality, which also occurred in very elderly and frailty subgroup. Kidney dysfunction was closely related to mortality in elderly patients with COVID-19.

Abbreviations BUN, blood urea nitrogen; UA, serum uric acid; Scr, serum creatinine; eGFR, estimated glomerular filtration rate; ICU, intensive care unit; AKI, acute kidney injury; CCB, calcium channel blocker; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; COPD, chronic obstructive pulmonary disease; AD, Alzheimer disease; ARB, angiotensin receptor blocker; IQR, interquartile range; ACE, angiotensin-converting enzyme; ACEI, angiotensin-converting enzyme inhibitor; cat L, cathepsin L; TMPRSS2, transmembrane protease serine 2. Ethical Approval The Ethics Committee of Zhejiang Hospital approved this study (2022-31J). Participants who took part in screening for geriatric syndrome were given written informed consent before participating in the study. All methods were carried out in accordance with relevant guidelines and regulations. Disclosure The authors have no conflicts of interest to declare that are relevant to the content of this article.

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