Admission systolic blood pressure and obesity correlate with fatal and severe acute COVID-19 in the population of New Orleans, LA

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ABSTRACT BACKGROUND In New Orleans, Louisiana (NOLA), the population’s very high social vulnerability led to the establishment of an early epicenter for severe acute COVID-19. Anticipating future respiratory virus outbreaks, identifying low-cost correlates of outcome relevant to special populations is crucial. METHODS 89 patients with acute COVID-19, enrolled March to August 2020 in the ClinSeqSer longitudinal observational study. RESULTS The cohort’s population, ∼70% Black, 53% female and 55% obese, reflects exactly that of greater urban NOLA; In contrast, pre-COVID hypertension (HTN) is 83% and 1.5 to 2-fold the state’s prevalence (43% among White, 56% among Black residents). Black patients are younger than White (∼50% vs <= 30% in 45-64 years age bracket). Outcomes were 47% severe, including 17% fatal, and 30% non-fatal (high flow or intubated), and identical by race/age. Obesity, BMI, admit systolic blood pressure (SBP), pulse BP, and CRP level, but not race, sex, age, type 2 diabetes, HTN, number or specific anti-HTN drugs, correlated with fatal and severe outcomes. Patients with admission SBP ≥140 mmHg reached severe clinical state sooner than those with lower SBP. CONCLUSIONS The very high proportion of pre-COVID HTN in this acute COVID cohort correlates with high social vulnerability. Obesity and SBP on admission stand out as risks for fatal and severe outcomes of acute COVID. The findings support further study of acute COVID admit SBP as a potential correlate of outcome, and the potential role for interactions between a single strain of SARS CoV-2 and the renin-angiotensin-aldosterone blood pressure axis.

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