Age but not sex may explain the negative effect of arterial hypertension and diabetes on COVID-19 prognosis

PIROLA, CARLOS J; SOOKOIAN, SILVIA

THE JOURNAL OF INFECTION.

W B SAUNDERS CO LTD

Año: 2020 vol. 81 p. 647 - 679

0163-4453

We read with great interest the article of Zheng and colleagues who summarized current evidence regarding risk factors for severe clinical forms of COVID-19.1 The authors concluded that patients who are males, aged over 65 and smoking might face a higher risk of developing into the critical or mortal condition by COVID-19.1 Besides, the authors highlighted that comorbidities such as hypertension, diabetes, cardiovascular and/or pre-existing respiratory diseases could also significantly affect the prognosis of the COVID-19.1 Collectively, the authors confirmed the negative effect of comorbidities on the natural course of COVID-19. Nevertheless, there are some aspects that need to be carefully assessed, including the influence of essential demographic confounding variables such as age and sex, which are also strongly associated with the above-mentioned comorbidities but unfortunately were not thoroughly included in the analysis.Hence, to answer the question of whether age and sex may influence the effect size/s of pre-existing comorbidities on COVID-19 severe prognosis, we used the data of the Zheng and coworkers1 as input to perform a meta-regression analysis. Of note, we found that the negative effect of underlying arterial hypertension on COVID-19 critical illness significantly and positively correlated with the age difference between critical/mortal and non-critical patients (slope±SE: 0.0718±0.021, p=0.00066) but not with the difference in male sex proportion (slope:-0.010±0.023, p=0.66) (Fig. 1, A/B). Likewise, the negative effect of type 2 diabetes on severe COVID-19 infection significantly and positively correlated with the age difference between the two groups (slope: 0.079±0.025, p=0.00185) but not with the difference in male proportion (slope:-0.040±0.027, p=0.133).