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People with hypertension, or high blood pressure, are most likely to develop complications when infected by Covid-19, says an analysis of medical records of over 1,800 patients admitted to hospitals run by the Mayo Clinic in the United States. A similar study of 18,000 Covid patients by Max Healthcare also established the role of hypertension in complications.
The findings could help hospitals give priority in treatment to patients susceptible to the listed complications.
The American study showed that hypertension was associated with 10 complications, including acute respiratory distress syndrome, improper beating of the heart and anaemia. In the analysis carried out using an artificial intelligence (AI) platform developed by nference Labs, a Bengaluru-based company, cardiovascular chronic disease (heart failure, coronary artery disease, cardiomyopathy) and chronic kidney disease proved the other most significant predictors of complication in early Covid infection.
The findings could help hospitals give priority in treatment to patients susceptible to the listed complications.
The American study showed that hypertension was associated with 10 complications, including acute respiratory distress syndrome, improper beating of the heart and anaemia. In the analysis carried out using an artificial intelligence (AI) platform developed by nference Labs, a Bengaluru-based company, cardiovascular chronic disease (heart failure, coronary artery disease, cardiomyopathy) and chronic kidney disease proved the other most significant predictors of complication in early Covid infection.
“These findings will help clinicians prioritise patients according to their vulnerability for developing complications and at the same time focus on the commonest complications that are associated with different co-morbidities and, thus, save lives,” Venky Soundararajan, co-founder and chief scientific officer of nference, the parent company of nference Labs, told TOI.
For the analysis, results of which have been accepted for publication in Nature Digital Medicine, Soundararajan explained the researchers leveraged 1.1 million clinical notes from 1,803 hospitalised Covid patients and deep neural network models to characterise associations between 21 pre-existing conditions and the development of 20 complications throughout the course of Covid infection. “Pleural effusion, or accumulation of fluid in the lungs, was the most common of early Covid infection complications (4.9%) followed by cardiac arrhythmia,”’ he said.
nference’s AI platform has been used previously for several discoveries regarding Covid — from demonstrating the “real-world” effectiveness and safety of the Covid vaccines manufactured by Moderna, Pfizer/BioNTech and Johnson & Johnson to finding that a loss of smell (anosmia) preceded a positive Covid test in many patients by up to a week before their diagnosis date. The AI platform also studied how mass vaccination was fundamentally restricting the evolution of SARS-CoV-2 variants (like alpha, beta, gamma, delta), the company said.
Dr Sandeep Budhiraja, group medical director of Max Healthcare, said his own hospital group’s study involving over 18,000 Covid patients similarly showed how hypertension was a major risk factor for developing complications due to the infection.
“The coronavirus that causes Covid enters the body by attaching itself to ACE-2 receptors on the cells in the lungs, liver, heart and kidneys,” said Budhiraja. “Initially, it was hypothesised that some of the blood pressure-lowering drugs led to the increase in the number of ACE-2 receptors, thus putting the organs at higher risk of colonisation by the virus and, therefore, increased severity. But that theory was proved wrong. Another hypothesis is that hypertension causes chronic inflammation and damage to the tissues. Covid aggravates it further leading to more complications,” Budhiraja said, adding that the jury on the matter was still out.
Dr Neeraj Nischal of AIIMS said that hypertension was a common comorbidity in older patients known to be at higher risk of complications. “The causal association between hypertension and morbidity and mortality still needs to be established though we have seen it is commonly associated with patients who have poor outcomes,” said Nischal. Dr Rajesh Chawla, senior consultant, pulmonary medicine and critical care, Apollo Hospitals, added, “It is important to control blood pressure to prevent severe disease. The prognosis of patients with uncontrolled hypertension is worse.”
nference’s AI platform has been used previously for several discoveries regarding Covid — from demonstrating the “real-world” effectiveness and safety of the Covid vaccines manufactured by Moderna, Pfizer/BioNTech and Johnson & Johnson to finding that a loss of smell (anosmia) preceded a positive Covid test in many patients by up to a week before their diagnosis date. The AI platform also studied how mass vaccination was fundamentally restricting the evolution of SARS-CoV-2 variants (like alpha, beta, gamma, delta), the company said.
Dr Sandeep Budhiraja, group medical director of Max Healthcare, said his own hospital group’s study involving over 18,000 Covid patients similarly showed how hypertension was a major risk factor for developing complications due to the infection.
“The coronavirus that causes Covid enters the body by attaching itself to ACE-2 receptors on the cells in the lungs, liver, heart and kidneys,” said Budhiraja. “Initially, it was hypothesised that some of the blood pressure-lowering drugs led to the increase in the number of ACE-2 receptors, thus putting the organs at higher risk of colonisation by the virus and, therefore, increased severity. But that theory was proved wrong. Another hypothesis is that hypertension causes chronic inflammation and damage to the tissues. Covid aggravates it further leading to more complications,” Budhiraja said, adding that the jury on the matter was still out.
Dr Neeraj Nischal of AIIMS said that hypertension was a common comorbidity in older patients known to be at higher risk of complications. “The causal association between hypertension and morbidity and mortality still needs to be established though we have seen it is commonly associated with patients who have poor outcomes,” said Nischal. Dr Rajesh Chawla, senior consultant, pulmonary medicine and critical care, Apollo Hospitals, added, “It is important to control blood pressure to prevent severe disease. The prognosis of patients with uncontrolled hypertension is worse.”
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