Comparative characterisation of COVID-19 patients with hypertension comorbidity in Malawi: a 1:2 matched retrospective case-control study

Objective: The aim of this study was to characterize COVID-19 cases and explore the risk factors associated with mortality among hypertensive patients with COVID-19 across Malawi.

Methods: A retrospective case-control study design was used to provide a detailed account of cases and to explore the risk factors associated with mortality among hypertensive patients with COVID-19. In total, 441 patients were included in the study in a ratio of one case to two controls (1:2), matched by age.

Results: Deaths due to COVID-19 varied with hypertensive condition, with more deaths registered in hypertensive patients. Clinical signs and symptoms varied greatly between hypertensive and non-hypertensive COVID-19 patients, tending to be milder in the latter group. The risk of death due to COVID-19 among hypertensive patients increased with age, and was meaningfully associated with underlining comorbidities, such as HIV, TB, cardiovascular disease, and liver disease.

Conclusion: Our study revealed predictive factors for mortality in hypertensive COVID-19 patients, which can be used by policy makers and healthcare practitioners to identify those at a higher risk, and to determine the appropriate treatment approach to achieve the best possible clinical outcomes.