Clinical course and consequences of coronavirus infection in patients with arterial hypertension

Abstract

Introduction. During the pandemic COVID-19, patients suffering from arterial hypertension were noticed to have more severe course of the coronavirus infection. Due to this reason there has been an increased interest to arterial hypertension as a predictor of unfavorable course of the disease. Aim. To conduct a literature review on the impact of cardiovascular diseases (including arterial hypertension) on the course and outcome of the novel coronavirus infection COVID-19. Materials and methods. The PubMed and eLibrary database was searched for information over the past five years on selected inclusion criteria. Information requests included the following keywords: COVID-19, cardiovascular diseases, angiotensin converting enzyme inhibitors, angiotensin II receptor blocker, arterial hypertension, arterial stiffness. Results. A retrospective analysis of the database of patients hospitalized with confirmed coronavirus infection (5700 people) in a New York City hospital correlates with the results of the conducted registry in the Russian Federation (ACTIV SARS-CoV-2), which included 5808 people. These studies confirm a more severe course of coronavirus infection in patients with an aggravated comorbid background (cardiovascular diseases, diabetes mellitus, obesity), and therefore, the level of need for intensive care in this category of patients increases. The article examines the mechanisms of the pathogenesis of COVID-19 associated with the angiotensin converting enzyme type II. We present the study results on the use of angiotensin converting enzyme inhibitors and angiotensin II receptor blocker in patients with cardiovascular diseases and COVID-19. The latest literature data showing the correlation of cardiac biomarkers with the severity of coronavirus infection and the presence of concomitant hypertension were analyzed. The results of studies of arterial stiffness in patients with COVID-19 with and without arterial hypertension are presented. Conclusion. The retrospective analysis of multicenter studies, conducted in various countries of the world, allows us to identify risk factors for the severity of COVID-19 with the development of complications and an increase in mortality. Timely assessment of predictors in patients with confirmed coronavirus infection will reduce the mortality rate.