Hypertensive disease after moderate coronavirus infection. The results of six-month follow-up

Abstract

Aim. This study aims to assess the clinical specificity of course of hypertensive disease (HD) during the first 6 months after new coronavirus infection (COVID-19) and to investigate prognostic significance of laboratory and instrumental parameters for organ dysfunctions in acute period of COVID-19 in patients with HD.Material and methods. The study included 82 patients. The main group included 50 patients with HD duration of at least 3 years, who received antihypertensive therapy and had confirmed moderate COVID-19. The control group included 32 patients with HD and without COVID-19. The mean age was 63,6±7,9 years and 66,6±10,3 years, respectively. The standard parameters of carbohydrate and lipid metabolism, inflammatory markers, hematological indicators, glomerular filtration rate (GFR) were measured, and also arterial pressure, Ps, to C, SpO2, peak expiratory flow rate (PEFR) were recorded. In 6 months we contacted by phone to conduct a survey concerning the 6-month period after hospitalization or outpatient examination with filling the questionnaire form SF-36.Results. Before inclusion, 76,5% and 83,3% of the patients in the main and control groups, respectively, took 1 hypotensive drug; 17,7% and 16,6% — 2-3 drugs; 5,9% (p<0,05) of the patients from the COVID-19 group took the drugs irregularily before hospitalization. In 6 months, 3% in each group took 1 hypotensive drug, 50% — 2 drugs, and 47% — 3 drugs. For the control group this was: 77% — 2 and 20% — 3, respectively. After analyzing the SF-36 form, we found that the worsening of emotional health in the group with HD and COVID-19 correlated (p<0,05) with initial SpO2 (r=-0,623), to C (r=-0,371), PEFR (r=0,423), and the degree of improvement — with GFR (r=0,339), total cholesterol (r=0,471) and platelet count (r=0,414). SF-36 also showed that in the main group, the worsening of physical health was associated with lower ALB (r=0,512), the higher increase of lactate dehydrogenase (r=0,342) and RBC (r=0,393).Conclusion. In 6 months after moderate COVID-19, the patients develop pronounced emotional and physical disorders as well as the worsening of HD clinical course. Regarding to this, the parameters reflecting severity of systemic inflammation, impairment of liver function and changes in brain function in acute COVID-19 possessed the prognostic significance.