The Level of Leukotriene B4 in Patients With Arterial Hypertension and Coronavirus Disease

Abstract

Relevance. Patients with comorbid pathology, including arterial hypertension (AH), coronary artery disease, type 2 diabetes, and cerebrovascular disease have been shown to be at risk for coronavirus disease (COVID-19). Currently, among the pathogenetic mechanisms of vascular endothelial damage are considered direct effects of SARS-COV-2 virus, as well as proinflammatory cytokines, which lead to a «cytokine storm» with unpredictable consequences for the patient. In this aspect, the role of leukotriene B4 (LTB4) – one of the first candidates to provoke a hyperimmune inflammatory response in the progression of COVID-19 – was insufficiently elucidated.
 Objective: to investigate the level of leukotriene B4 (LTB4) in patients with AH with and without coronavirus disease 2019.
 Methods. 78 people with AH and overweight or obesity who were treated at the Lviv Emergency Hospital were examined. All patients were divided into 2 groups: group 1 (n=37) – persons with AH (stage І-ІІІ, grade 1-3); group 2 (n=41) – patients with AH (stage І-ІІІ, grade 1-3), COVID -19 and interstitial lung disease.
 Anthropometric measurements with a determination of body mass index (BMI), echocardiography, a blood test, biochemical blood test with determination of glucose, alanine aminotransferase, aspartate aminotransferase, creatinine, and urea were performed. Serum blood samples for the examination of LTB4 (Elabscience Elisa Kit) were taken and processed using ELISA method.
 Results. Saturation was significantly lower in patients of group 2, while heart rate and body temperature were higher (p < 0,01) compared to group 1. There was a significant decrease in hemoglobin level, increase in ESR, glucose, and LTB4 in individuals with AH and COVID-19, which is probably due to the presence of inflammation in the lung tissue in coronavirus infection. The concentration of LTB4 ranged from 370 to 3600 pg/l in patients of group 2. 19 individuals (46,3%) of group 2 had a higher level of LTB4 than the median value, which is probably associated with a more severe course of coronavirus infection. A positive correlation between LTB4 and BMI (rs= 0,369; p < 0,05) was found in individuals with AH.
 Conclusions. The level of LTB4 is higher in patients with AH and COVID – 19 than in individuals with AH, due to the severity of the inflammation process in this comorbid pathology.