Background and importanceIdentification of the angiotensin converting enzyme (ACE2) as a target of the SARS-CoV-2 virus raises questions about a possible change in the clinical course of this infection associated with inhibitors of the renin–angiotensin–aldosterone system (RAAS). Furthermore, high blood pressure is considered a risk factor for COVID-19.Aim and objectivesTo characterise the clinical course in hypertensive patients admitted for COVID-19 and to determine if treatment with RAAS inhibitors, age and additional comorbidities may be related to mortality and development of acute respiratory distress syndrome (ARDS).Material and methodsA single centre, observational, retrospective study was conducted. Inclusion criteria were: diagnosis of hypertension, hospital admission for COVID-19 between 1 March and 24 March 2020. Demographic, clinical and analytical variables were recorded. Clinical course was evaluated by: development of bilateral pneumonia, ARDS, length of stay and mortality. End of follow-up was 10 October 2020. To evaluate the possible influence of factors on evolution, binary logistic regression was performed using the STATA-IC14 programme. Quantitative dependent variables were transformed into dichotomous variables. Statistical significance was defined as p<0.05.Results571 patients were analysed, with a median age of 76 years (IQR 66–83) and 59.2% were men. Of these, 69.7% were receiving treatment with RAAS inhibitors, 7.2% smoked and 80.0% had additional comorbidities. At hospital admission, 27.3% presented with hypoxaemia (SatO2<90%), 64.3% lymphopenia (<1000/mm3), 18.8% C reactive protein >20 mg/dL and 11.7% D-dimer >1200 ng/mL. During the hospital stay, 91.9% of patients required oxygen therapy, 76.4% developed bilateral pneumonia, 91.9% required oxygen therapy, 47.5% developed ARDS and 33.6% died. Median hospital stay was 15 days (IQR 9–24). Use of RAAS inhibitors was not linked to changes in mortality or development of ARDS (p>0.05).Risk factors associated with mortality were: additional cardiovascular diseases (OR=2.10; p=0.000) and older age (OR=1.05; p=0.000). Regarding ARDS, we found an association with obesity (OR=1.77; p=0.013), diabetes mellitus (OR=1.84; p=0.001) and age (OR=1.02; p=0.010). Hospital stay >14 days was significantly longer in advanced age (OR=1.02; p=0.022) and if chronic kidney disease was present (OR=1.73, p=0.043).Conclusion and relevanceAntihypertensive treatment with RAAS inhibitors did not seem to be linked to the risk of worse evolution of COVID-19. Advanced age and additional cardiovascular disease appeared to be associated with higher mortality in hypertensive patients.References and/or acknowledgementsAngel-Korman A, et al. COVID-19, the kidney and hypertension. Harefua 2020;159:231–4. https://pubmed.ncbi.nlm.nih.gov/32307955/Conflict of interestNo conflict of interest...

5PSQ-134 Analysis of factors related to the clinical course of COVID-19 infection in patients with hypertension

10.1136/ejhpharm-2021-eahpconf.253