COVID-19 and arterial hypertension: whether normal blood pressure is a sign of a benign course of COVID-19

O.V.  Kuryata; Ye.O.  Frolova; O.I.  Stadnyk; V.V.  Semenov

doi:10.26641/2307-0404.2023.4.294029

Автор(и)

O.V. Kuryata Dnipro state medical university, Volodymyra Vernadskoho str., 9, Dnipro, 49044, Україна https://orcid.org/0000-0001-7642-0077
Ye.O. Frolova Dnipro state medical university, Volodymyra Vernadskoho str., 9, Dnipro, 49044, Україна https://orcid.org/0000-0002-8546-1601
O.I. Stadnyk Dnipro State Medical University, Volodymyra Vernadskoho str., 9, Dnipro, 49044, Україна https://orcid.org/0000-0001-8253-5524
V.V. Semenov Dnipro State Medical University, Volodymyra Vernadskoho str., 9, Dnipro, 49044, Україна https://orcid.org/0000-0003-3363-0159

DOI:

https://doi.org/10.26641/2307-0404.2023.4.294029

Ключові слова:

hypertension, disease severity, blood pressure

Анотація

SARS-CoV-2 virus, which causes coronavirus disease 2019 (COVID-19), apart from respiratory manifestations, is able to directly affect the cardiovascular system. Therefore, different from general population target values of blood pressure might be beneficial for the patients with COVID-19. The aim of this study was to investigate whether conventional blood pressure control was associated with the severity of COVID-19. From 260 patients that were hospitalised to the unit subdivision of stable patients of COVID-center between March, 2020, and December, 2020, 163 patients with confirmed infection with SARS-CoV-2 virus and hypertension were selected. The patients were distributed by hypertension control: blood pressure <140/90 mmHg (n=94) and blood pressure ≥140/90 mmHg (n=69). Routine instrumental and laboratory investigations were registered and analysed. The patients were diagnosed and treated according to national and European guidelines. The information about the control of blood pressure was taken from the patients’ medical records. The group of patients with controlled hypertension had higher prevalence of females (p=0.03), 10 years higher median of age (p<0.01) and lower frequency of obesity (p=0.04). The patients with controlled hypertension had lower median of pulmonary injury (p=0.04) and lower frequency of SpO₂<92% (p=0.02). Glomerular filtration rate <60 ml/min and proteinuria were detected significantly more frequently in the patients with controlled hypertension (p=0.02). In the presented study blood pressure below 140/90 mmHg before the admission to the hospital was associated with a lower degree of pulmonary injury but with the higher frequency of nephropathy signs. Urine test and blood creatinine monitoring might be beneficial for the patients with COVID-19 and hypertension.

Посилання

Gallo G, Calvez V, Savoia C. Hypertension and COVID-19: Current Evidence and Perspectives. High Blood Press Cardiovasc Prev. 2022 Mar;29(2):115-23. doi: https://doi.org/10.1007/s40292-022-00506-9

Cannatà A, Bromage DI, McDonagh TA. The collateral cardiovascular damage of COVID-19: only history will reveal the depth of the iceberg. Eur Heart J. 2021 Apr 14;42(15):1524-7. doi: https://doi.org/10.1093/eurheartj/ehab097

Holt A, Gislason GH, Schou M, Zareini B, Biering-Sørensen T, Phelps M, et al. New-onset atrial fibrillation: incidence, characteristics, and related events fol¬lowing a national COVID-19 lockdown of 5.6 million people. Eur Heart J. 2020 Jun 1;41(32):3072-9. doi: https://doi.org/10.1093/eurheartj/ehaa494

Farshidfar F, Koleini N, Ardehali H. Cardiovascular complications of COVID-19. JCI Insight. 2021;6(13):148980. doi: https://doi.org/10.1172/jci.insight.148980

Task Force for the management of COVID-19 of the European Society of Cardiology. ESC guidance for the diagnosis and management of cardiovascular disease du¬ring the COVID-19 pandemic: part 2-care pathways, treatment, and follow-up. Eur Heart J. 2022 Mar 14;43(11):1059-103. doi: https://doi.org/10.1093/eurheartj/ehab697

Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health. 2020 Aug 1;20:1193. doi: https://doi.org/10.1186/s12889-020-09301-4

Kagiyama N, Hiki M, Matsue Y, Dohi T, Matsuzawa W, Daida H, et al. Validation of telemedicine-based self-assessment of vital signs for patients with COVID-19: A pilot study. J Telemed Telecare. 2021 Sep 29;29(8);600-6. doi: https://doi.org/10.1177/1357633X211011825

[Organization of medical assistance for patients with the coronavirus disease (COVID-19). Order of the Ministry of Health of Ukraine dated 2020 Mar 28, No. 722]. [Internet]. 2020 [cited 2022 Sep 27]. Ukrainian. Available from: https://zakon.rada.gov.ua/go/v0722282-20

[On the approval of the protocol "Providing medi-cal assistance for the treatment of the coronavirus disease (COVID-19)". Order of the Ministry of Health of Ukraine dated 2020 Apr 2, No. 762]. [Internet]. 2020 [cited 2022 Sep 27]. Ukrainian. Available from: https://zakon.rada.gov.ua/go/v0762282-20

Williams B, Mancia G, Spiering W, Agabiti Ro-sei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-104. doi: https://doi.org/10.1093/eurheartj/ehy339

Messiah S. Body Mass Index. In: Gellman MD, Turner JR, editors. Encyclopedia of Behavioral Medicine. [Inter¬net]. New York, NY: Springer; 2013 [cited 2023 Sep 13]:247-9. doi: https://doi.org/10.1007/978-1-4419-1005-9_729

Eknoyan G, Lameire N, Echardt K, et al. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013;3(1):1-150. doi: https://doi.org/10.1038/kisup.2012.74

R Core Team. R: A language and environment for statistical computing [Internet]. Vienna, Austria: R Foundation for Statistical Computing, Vienna, Austria; 2022 [cited 2023 Sep 13]. Available from:

https://www.R-project.org/

Petrie A, Sabin C. Medical statistics at a glance. 4th ed. Hoboken, NJ: Wiley-Blackwell; 2019. doi: https://doi.org/10.33029/9704-5904-1-2021-NMS-1-232

Raimondi F, Novelli L, Ghirardi A, Russo FM, Pellegrini D, et al. Covid-19 and gender: lower rate but same mortality of severe disease in women – an obser-vational study. BMC Pulm Med. 2021 Mar 20;21(1):96. doi: https://doi.org/10.1186/s12890-021-01455-0

Vulturar DM, Crivii CB, Orăsan OH, Palade E, Buzoianu AD, Zehan IG, et al. Obesity Impact on SARS-CoV-2 Infection: Pros and Cons “Obesity Paradox”—A Systematic Review. J Clin Med. 2022 Jul 2;11(13):3844. doi: https://doi.org/10.3390/jcm11133844

Ivanov DD, Kuriata OV, Harmish IP. [Blockers of the renin-angiotensin-aldosterone system: chronic kidney disease and cardiovascular risk]. Nyrky. 2018;7(2):81-90. Ukrainian.

doi: https://doi.org/10.22141/2307-1257.7.2.2018.127393

Meijers B, Hilbrands LB. The clinical characteristics of coronavirus-associated nephropathy. Nephrol Dial Transplant. 2020 Aug;35(8):1279-81. doi: https://doi.org/10.1093/ndt/gfaa197

Ahmadian E, Hosseiniyan Khatibi SM, Razi Soofiyani S, Abediazar S, Shoja MM, Ardalan M, et al. Covid-19 and kidney injury: Pathophysiology and molecu¬lar mechanisms. Rev Med Virol. 2021;31(3):e2176. doi: https://doi.org/10.1002/rmv.2176

Portolés J, Marques M, López-Sánchez P, de Valdenebro M, Muñez E, Serrano ML, et al. Chronic kidney disease and acute kidney injury in the COVID-19 Spanish outbreak. Nephrol Dial Transplant. 2020 Aug;35(8):1353-61. doi: https://doi.org/10.1093/ndt/gfaa189