Introduction: As the outbreak of coronavirus disease 2019 (COVID‑19) was recognized, the clinical predictors of severe or fatal course of the disease should be identified to enable risk stratification and to allocate limited resources optimally. Hypertension has been widely reported to be associated with increased disease severity; however, some studies reported different findings.
Objectives: The study aimed to evaluate the association between hypertension and severe and fatal COVID‑19.
Patients and methods: The Scopus, Medline, and Web of Science databases were searched to identify studies reporting the rate of hypertensive patients in the population diagnosed with severe or nonsevere COVID‑19 or in COVID-19 survivors and nonsurvivors. The obtained data were pooled into a meta‑analysis to calculate odds ratios (ORs) with 95% CIs.
Results: Hypertension was associated with a nearly 2.5‑fold increased risk of severe COVID‑19 (OR, 2.49; 95% CI, 1.98-3.12; I2 = 24%), as well as with a similarly significant higher mortality risk (OR, 2.42; 95% CI, 1.51-3.90; I2 = 0%). In a meta‑regression analysis, a correlation was observed between an increase in the mean age of patients with severe COVID‑19 and an increased log OR of hypertension and COVID-19 severity (P = 0.03).
Conclusions: This pooled analysis of the current literature would suggest that hypertension may be associated with an up to 2.5‑fold higher risk of severe or fatal COVID‑19, especially in older individuals.