The condition of target organs in patients with hypertension after new coronavirus infection

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Abstract

Objective. To determine the risk factors for the development of new coronavirus infection (NCVI) in patients with hypertension (AH) and to assess the condition of target organs depending on the course of NCVI.

Materials and methods. A screening clinical observational comparative study is presented. For a 2-year period 186 patients with a history of AH or with a first-time BP increase who consulted a general practitioner in an outpatient department were sequentially included into the study in accordance with the inclusion and non-inclusion criteria. The patients were divided into two groups depending on the presence of NCVI: the first group consisted of 100 patients with AH or first-onset AH who had had NCVI; the second group contained 86 patients with AH or first-time AH without a history of NCVI. All patients with AHunderwent a comprehensive routine clinical examination with an assessment of target organ damage in accordance with clinical guidelines within 14 days after visiting the polyclinic with an assessment of the data of the outpatient card and other medical documents to register concomitant diseases and conditions, as well as the features of the course of NCVI.

Results. Vaccination against NCVI in patients with AH reduces the relative risk (RR) of the development not only of NCVI by 87 %, but NCVI-pneumonia with hospitalization and prolonged post-COVID syndrome as well. It has been proved that obesity with a body mass index of > 30 g/m2, atherosclerosis of any localization, type 2 diabetes mellitus increase the RR of the development of various forms of NCVI, including a prolonged course of more than 12 weeks. Newly diagnosed chronic heart failure (CHF), verified not only by clinical symptoms, but also by echocardiography and N-terminal fragment of brain natriuretic propeptide (Nt-proBNP) concentration in the blood, increases the RR of the development of NCVI by 48.2 %, NCVI- pneumonia with hospitalization, and the prolonged course of NCVI by more than 2 times. An increase in Nt-proBNP > 125 pg/ml in patients with AH even without CHF is associated with the development of various forms of NCVI, including post-COVID syndrome. The use of renin-angiotensin-aldosterone system (RAAS) blockers, dual combined antihypertensive therapy in patients with AH reduced the RR of the development of both NCVI, NCVI-pneumonia with hospitalization and the prolonged course of NCVI on an average by 30 to 50 %. The use of sulfonylureas and/or insulin therapy in patients with AH and type 2 diabetes mellitus was associated with an increase in the RR of the development of NCVI by 73.6 %, the RR of the development of NCVI-pneumonia with hospitalization was more than 4 times higher, and a prolonged course of NCVI almost 3 times higher. Average daily pulse blood pressure and abnormal patterns of circadian rhythm of SBP and DBP were associated with an increase in RR of both acute and chronic forms of long-term NCVI. NСVI- pneumonia with hospitalization and post-COVID syndrome are associated with an increase in the RR of pathological changes in all target organs in patients with AH in comparison with patients who did not have any complications after NCVI.

Conclusion. Known risk factors for the development of various forms of NCVI, including its prolonged course in patients with AH, have been confirmed and new ones have been revealed. It has been determined that NCVI with a severe course and post-COVID syndrome are associated with pathological changes in all target organs in patients with AH after NCVI.

About the authors

N. M. Syuzeva

E.A. Vagner Perm State Medical University

Email: nakoziolova@mail.ru
ORCID iD: 0000-0001-8754-2950

Assistant of the Department of Propaedeutics of Internal Diseases №2

 

Russian Federation, Perm

N. A. Koziolova

E.A. Vagner Perm State Medical University

Author for correspondence.
Email: nakoziolova@mail.ru
ORCID iD: 0000-0001-7003-5186

DSc (Medicine), Professor, Head of the Department of Propaedeutics of Internal Diseases № 2

Russian Federation, Perm

A. I. Chernyavina

E.A. Vagner Perm State Medical University

Email: nakoziolova@mail.ru
ORCID iD: 0000-0002-0051-6694

DSc (Medicine), Associate Professor of the Department of Propaedeutics of Internal Diseases №2

Russian Federation, Perm

O. V. Masalkina

E.A. Vagner Perm State Medical University

Email: nakoziolova@mail.ru
ORCID iD: 0009-0006-3364-0591

PhD (Medicine), Associate Professor of the Department of Propaedeutics of Internal Diseases №2

Russian Federation, Perm

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