tetano
Editor, Senior Moderator
PLoS One
. 2021 Apr 28;16(4):e0250815.
doi: 10.1371/journal.pone.0250815. eCollection 2021.
Hypertension as a sequela in patients of SARS-CoV-2 infection
Ganxiao Chen[SUP] 1 [/SUP], Xun Li[SUP] 2 [/SUP], Zuojiong Gong[SUP] 2 [/SUP], Hao Xia[SUP] 1 [/SUP], Yao Wang[SUP] 2 [/SUP], Xuefen Wang[SUP] 3 [/SUP], Yan Huang[SUP] 1 [/SUP], Hector Barajas-Martinez[SUP] 4 [/SUP], Dan Hu[SUP] 1 [/SUP]
Affiliations
Abstract
Background: COVID-19 is a respiratory infectious disease caused by SARS-CoV-2, and cardiovascular damage is commonly observed in affected patients. We sought to investigate the effect of SARS-CoV-2 infection on cardiac injury and hypertension during the current coronavirus pandemic.
Study design and methods: The clinical data of 366 hospitalized COVID-19-confirmed patients were analyzed. The clinical signs and laboratory findings were extracted from electronic medical records. Two independent, experienced clinicians reviewed and analyzed the data.
Results: Cardiac injury was found in 11.19% (30/268) of enrolled patients. 93.33% (28/30) of cardiac injury cases were in the severe group. The laboratory findings indicated that white blood cells, neutrophils, procalcitonin, C-reactive protein, lactate, and lactic dehydrogenase were positively associated with cardiac injury marker. Compared with healthy controls, the 190 patients without prior hypertension have higher Ang? level, of which 16 (8.42%) patients had a rise in blood pressure to the diagnostic criteria of hypertension during hospitalization, with a significantly increased level of the cTnI, procalcitonin, angiotensin-II (Ang?) than those normal blood pressure ones. Multivariate analysis indicated that elevated age, cTnI, the history of hypertension, and diabetes were independent predictors for illness severity. The predictive model, based on the four parameters and gender, has a good ability to identify the clinical severity of COVID-19 in hospitalized patients (area under the curve: 0.932, sensitivity: 98.67%, specificity: 75.68%).
Conclusion: Hypertension, sometimes accompanied by elevated cTnI, may occur in COVID-19 patients and become a sequela. Enhancing Ang II signaling, driven by SARS-CoV-2 infection, might play an important role in the renin-angiotensin system, and consequently lead to the development of hypertension in COVID-19.
. 2021 Apr 28;16(4):e0250815.
doi: 10.1371/journal.pone.0250815. eCollection 2021.
Hypertension as a sequela in patients of SARS-CoV-2 infection
Ganxiao Chen[SUP] 1 [/SUP], Xun Li[SUP] 2 [/SUP], Zuojiong Gong[SUP] 2 [/SUP], Hao Xia[SUP] 1 [/SUP], Yao Wang[SUP] 2 [/SUP], Xuefen Wang[SUP] 3 [/SUP], Yan Huang[SUP] 1 [/SUP], Hector Barajas-Martinez[SUP] 4 [/SUP], Dan Hu[SUP] 1 [/SUP]
Affiliations
- PMID: 33909683
- DOI: 10.1371/journal.pone.0250815
Abstract
Background: COVID-19 is a respiratory infectious disease caused by SARS-CoV-2, and cardiovascular damage is commonly observed in affected patients. We sought to investigate the effect of SARS-CoV-2 infection on cardiac injury and hypertension during the current coronavirus pandemic.
Study design and methods: The clinical data of 366 hospitalized COVID-19-confirmed patients were analyzed. The clinical signs and laboratory findings were extracted from electronic medical records. Two independent, experienced clinicians reviewed and analyzed the data.
Results: Cardiac injury was found in 11.19% (30/268) of enrolled patients. 93.33% (28/30) of cardiac injury cases were in the severe group. The laboratory findings indicated that white blood cells, neutrophils, procalcitonin, C-reactive protein, lactate, and lactic dehydrogenase were positively associated with cardiac injury marker. Compared with healthy controls, the 190 patients without prior hypertension have higher Ang? level, of which 16 (8.42%) patients had a rise in blood pressure to the diagnostic criteria of hypertension during hospitalization, with a significantly increased level of the cTnI, procalcitonin, angiotensin-II (Ang?) than those normal blood pressure ones. Multivariate analysis indicated that elevated age, cTnI, the history of hypertension, and diabetes were independent predictors for illness severity. The predictive model, based on the four parameters and gender, has a good ability to identify the clinical severity of COVID-19 in hospitalized patients (area under the curve: 0.932, sensitivity: 98.67%, specificity: 75.68%).
Conclusion: Hypertension, sometimes accompanied by elevated cTnI, may occur in COVID-19 patients and become a sequela. Enhancing Ang II signaling, driven by SARS-CoV-2 infection, might play an important role in the renin-angiotensin system, and consequently lead to the development of hypertension in COVID-19.