The impact of systemic hypertension on outcomes in hospitalized COVID-19 patients - a systematic review.

Background: Several observational reports from different parts of the world have shown that systemic hypertension (hypertension) was the single commonest comorbid condition in hospitalized COVID-19 patients. Hypertension is also the most prevalent comorbidity reported among patients who developed severe disease, were admitted to Intensive Care Unit, needed mechanical ventilatory support, or who died on admission. The objective of this systematic review is to study the association between hypertension and specific clinical outcomes of COVID-19 disease which are- development of severe COVID-19 disease, need for admission in the intensive care unit (ICU) or critical care unit (CCU), need for mechanical ventilation or death. Methods: We searched the PubMed, SCOPUS, and Google Scholar databases up till June 28, 2020 for original research articles that documented the risk factors of mortality in patients with COVID-19 using the PRISMA guideline. Results: One hundred and eighty-two articles were identified using pre-specified search criteria, of which 33 met the study inclusion criteria. Only three were prospective studies. Most studies documented hypertension as the most prevalent comorbidity. The association of hypertension with development of severe COVID-19 disease was not conclusive, majority of studies however found an associated with mortality. Conclusion: Hypertension affects the clinical course and outcome of COVID-19 disease in many cohorts. Prospective studies are needed to further understand this relationship.

Burden of Care and Psychological Distress in Primary Caregivers of Patients with Type -2 Diabetes Mellitus in A Tertiary Hospital in Nigeria.

BACKGROUND: Caregivers play an important role in the management and care of individuals with chronic medical conditions. This is because; they provide emotional, physical, financial as well as spiritual support to their wards. However, the process of caregiving is usually associated with feelings of burden and psychological distress. METHODS: This study was a descriptive, cross-sectional, clinic-based study done at the endocrinology clinic of a Teaching hospital in Northern Nigeria. It was done utilizing the Zarit Burden Interview, the General Health Questionnaire (12 item version) and a socio-demographic questionnaire designed by the authors. The levels of burden as well as the factors associated with burden and psychological distress in one hundred caregivers of patients with Type 2 Diabetes Mellitus were assessed. Statistical analysis was done using chi square, independent T test and linear regression. RESULTS: Forty- two percent (42%) of caregivers experienced little or no burden, 47% had mild to moderate burden, 8% had moderate to severe burden, while 3% had severe burden. When the ZBI scores were dichotomized into 'low' and 'high' burden, 89% were found to experience low burden, while 11% experienced high burden. On logistic regression, females were found to be four times more likely to experience high burden, while Thirty-five (35%) percent of caregivers had a GHQ score of > 3, signifying psychological distress and psychological distress was found to be significantly associated with burden. CONCLUSION: Many Nigerian caregivers of patients with Type 2 Diabetes Mellitus experience burden and psychological distress associated with caregiving, especially female caregivers and those taking care of those taking care of patients with complications. It is therefore important for clinicians to recognize burdened caregivers and intervene appropriately in order to improve the quality of care of these patients.