COVID-19 and hypertension: risks and management. A scientific statement on behalf of the British and Irish Hypertension Society

Clark, Christopher E; McDonagh, Sinéad T J; McManus, Richard J; Martin, Una

doi:10.1038/s41371-020-00451-x

Cited by 65 publications

(52 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The patients with hypertension have a ~ 17-fold higher risk of hospitalization than those without hypertension, in line with previous reports [17,19]. The effect of hypertension on COVID-19 severity is controversial [20]. The pathogenesis of hypertension affecting the COVID-19 severity is complex [20].…”

Section: Discussionsupporting

confidence: 84%

“…However, our study did not show an association between the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/IRB) and COVID-19 severity. Similar to hypertension, the effect of ACEI/IRB on COVID-19 severity is still inconclusive [20]. The S protein of SARS-CoV-2 binds to the ACE2 receptor to enter the human cells, suggesting that the use of ACEI/IRB might worsen the prognosis of COVID-19 [22].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of SARS-CoV-2 Multiple Spike Protein Mutations on COVID-19 Outcomes

Gunadi

Hakim

Wibawa

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Recent studies focusing on the association of SARS-CoV-2 variants of concern (VOC) on COVID-19 outcomes have been reported. However, studies of the impact of multiple mutations within the spike (S) protein of SARS-CoV-2 on COVID-19 illness are limited. This study determined the association between multiple mutations within the S protein, prognosis factors, and the disease outcomes of SARS-CoV-2 infection. Methods: We included 51 COVID-19 patients from Yogyakarta and Central Java, Indonesia. Whole genome sequences of SARS-CoV-2 were determined by the Illumina MiSeq next-generation sequencer, followed by the phylogenetic analysis of 170 full-genomes of SARS-CoV-2 from different regions. We analyzed characteristics of COVID-19 patients and multiple mutations in association with different outcomes.Results: Among 51 patients, the clinical manifestations of COVID-19 were as follows: without any symptoms (13.7%), mild (47%), moderate (19.6%), severe (4%), critical (2%), and died (13.7%). The age of hospitalized patients (53.4 ± 18 years) was higher than non-hospitalized patients (34.6 ± 19) (p=0.001). A significant association between diabetes, hypertension, and anticoagulant and the hospitalization of patients was noted with p-value of 0.039 (OR=4.47 [95% CI=1.07-18.58]), 0.001 (OR=17 [95% CI=2-144]), and 0.02 (OR=27.97 [95% CI=1.54-507.13]), respectively; whereas a strong association between patients’ age, diabetes, anticoagulant, and steroid with the mortality of patients was revealed with p-value of 0.016 (OR=8.44 [95% CI=1.5-47.49]), 0.019 (OR=8.5 [95% CI=1.43-50.66]), 0.001 (46.8 [95% CI=4.63-472.77]), and 0.009 (OR=15.75 [95% CI=2-123.86]), respectively. All viruses contained the D614G variant, except one case. Accordingly, the samples were classified as the following clade: L (2%), GH (84.3%), GR (11.7%), and O (2%). Besides the D614G, the most common variants in the S protein were L5F (18.8%), V213A (18.8%), and S689R (8.3%). There was no significant association between multiple S protein variants with either hospitalization or mortality of COVID-19 (p=0.11 and 0.69, respectively). Multivariate analysis showed that hypertension and anticoagulant were the strong factors affecting the hospitalization and mortality of patients with COVID-19 with a p-value of 0.009 (OR=17.06 [95% CI=2.02-144.36]) and 0.001 (OR=46.8 (95% CI=4.63-472.77), respectively. Interestingly, the multiple S protein variants almost reached a significant level affecting the hospitalization of patients (p=0.07). Phylogenetic analysis showed that although most of the viruses from this study belonged to clade GH, none were detected as the variant of concern (VOC) and the variant of interest (VOI) of SARS-CoV-2.Conclusions: Here, we show for the first time the association between SARS-CoV-2 mutations within the S protein besides the VOC with the COVID-19 outcomes. Our findings suggest that multiple mutations in the S protein might affect the severity of COVID-19. Our study further suggests the importance of genomic surveillance to monitor SARS-CoV-2 variants, particularly those that might influence the outcomes of COVID-19 patients.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

The Impact of SARS-CoV-2 Multiple Spike Protein Mutations on COVID-19 Outcomes

Gunadi

Hakim

Wibawa

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The impact of MetS and its components imposes a significant burden on the healthcare system and the country’s economy. It is further aggravated by the COVID-19 pandemic since it is a well-known fact that MetS and its components are risk factors strongly influencing the progression and prognosis of the disease [ 34 , 35 , 36 , 37 ]. Moreover, studies have also shown that ethnic minorities are less likely to follow the Government’s restrictions designed to stop the spread of COVID-19 [ 38 ] and tend to have a more critical attitude towards vaccination [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Changes in the Prevalence of Metabolic Syndrome, Its Components, and Relevant Preventive Medication between 2011 and 2018 in the Northeast Hungarian Roma Population

Pikó

Diószegi

Kósa

et al. 2021

JPM

View full text Add to dashboard Cite

Metabolic syndrome (MetS) is a cluster of clinical conditions that poses a major health burden worldwide. In the present study, we investigate the changes in the prevalence of MetS and its components among the Roma in two disadvantaged counties in Northeastern Hungary focusing on a seven-year-long period. The database of the present study is based on cross-sectional surveys of the Hungarian Roma population (aged 20–64 years) conducted in 2011 (n = 458) and 2018 (n = 374). The increase in the prevalence of MetS itself in the whole Roma population was not found to be significant in the period examined (although it increased from 40.0% up to 46.0%, p = 0.080); however, regarding its components, there was a significant increase in the prevalence of central obesity (from 62.7% to 73.3%, p = 0.001) and raised blood pressure (BP) or treated hypertension (from 45.2% to 54.5%, p = 0.007). These changes were mainly observed in the younger age groups, so the risk for MetS increased significantly in the 20–34 (OR = 1.10, p = 0.038) and 35–49 (OR = 1.07, p = 0.048) year age groups in the 2018 study population compared the 2011 one. The increasing prevalence of hidden hypertension and, consequently, untreated individuals with raised BP (from 29.6% to 43.5%, p = 0.014) among females is quite alarming; therefore, a targeted public health strategy and targeted interventions are desperately needed to prevent further worsening of the current situation.

show abstract

“…COVID-19 patients with hypertension might increase severity and mortality rates. Hypertension should consider as a clinical predictor for the severity of COVID-19 both in adults and children [10]. Also, diabetes is another comorbidity to increase the COVID-19 disease burden and mortality worldwide [11,12].…”

Section: Introductionmentioning

confidence: 99%

Hematological abnormalities and comorbidities are associated with COVID-19 severity among hospitalized patients: Experience from Bangladesh

et al. 2021

View full text Add to dashboard Cite

Background The hematological abnormalities are assumed to be involved in the disease progression of COVID-19. However, the actual associations between specific blood parameters and COVID-19 are not well understood. Here we aimed to assess the correlations between hematological parameters and the severity of COVID-19. Methods We included COVID-19 patients who were admitted to Evercare Hospital Ltd, Dhaka, Bangladesh, between November 10, 2020, to April 12, 2021, with a confirmed case of RT-PCR test. We recorded demographic information, clinical data, and routine hematological examination results of all COVID-19 patients. We performed statistical analyses and interpretation of data to compare severe COVID-19 patients (SCP) and non-severe COVID-19 patients (NSCP). Results The age and BMI of the admitted COVID-19 patients were 48.79±8.53 years and 25.82±3.75 kg/m2. This study included a total of 306 hospitalized COVID-19 patients. Among them, NSCP and SCP were 198 and 108, respectively. And we recorded 12 deaths from SCP. We observed the alterations of several hematological parameters between SCP and NSCP. Among them, we noticed the increased levels of C-reactive protein (CRP), d-dimer, and ferritin showed good indicative value to evaluate the severity of COVID-19. Also, there were positive correlations among these parameters. Moreover, we found correlations between the outcomes of COVID-19 patients with patient’s demographics and comorbid diseases. Conclusion Based on our results, CRP, d-dimer, and ferritin levels at admission to hospitals represent simple assessment factors for COVID-19 severity and the treatment decisions at the hospital setup. These blood parameters could serve as indicators for the prognosis and severity of COVID-19. Therefore, our study findings might help to develop a treatment protocol for COVID-19 patients at the hospital setup.

show abstract

COVID-19 and hypertension: risks and management. A scientific statement on behalf of the British and Irish Hypertension Society

Cited by 65 publications

References 27 publications

The Impact of SARS-CoV-2 Multiple Spike Protein Mutations on COVID-19 Outcomes

The Impact of SARS-CoV-2 Multiple Spike Protein Mutations on COVID-19 Outcomes

Changes in the Prevalence of Metabolic Syndrome, Its Components, and Relevant Preventive Medication between 2011 and 2018 in the Northeast Hungarian Roma Population

Hematological abnormalities and comorbidities are associated with COVID-19 severity among hospitalized patients: Experience from Bangladesh

Contact Info

Product

Resources

About