Hypertension and COVID-19 in the conditions of the Arctic watch (according to the data of the medical unit in Yamburg)

Abstract

Objective. To study the peculiarities of COVID-19 course and gender differences in patients with arterial hypertension (HTN) in the conditions of the Arctic watch.Design and methods. In the settlement of Yamburg (Nadym district), 517 case histories were retrospectively analyzed by random sampling: 359 men (M) and 158 females (F) treated as inpatients at the medical unit of GAZPROM DOBYCHA YAMBURG LLC in the period 2019–2021. Of these, a diagnosis of COVID-19 was verified in 233 M (with HTN — 150 M (64 %) and 77 F (with HTN — 51 F (66 %)); and those without COVID-19: 126 M (with HTN — 77 M (61 %) and 81 F (with HTN — 38 F (47 %)). The diagnosis of COVID-19 was based on the detection of SARS-CoV-2 RNA by polymerase chain reaction. Retrospective analysis was performed as part of routine clinical practice; patients gave written informed consent for data processing according to the order No. 36/1 dated 29.01.2020 and the approved informed consent form.Results. M and F groups who survived after COVID-19 were significantly older than those who did not. The largest number of COVID-19 patients among M and F were from the group of interregional watch — rotations from temperate regions without crossing the time zone (Tyumen, Ufa, Tobolsk), the smallest — from the group of intraregional watch (coming on a rotation from the Far North — cities Nadym, Novy Urengoy). Correlation analysis showed direct significant relationships between COVID-19 and age (p = 0,009), northern experience (p = 0,006), and history of HTN (p = 0,002). Patients with HTN who survived after COVID-19 were significantly more likely to have grade II obesity. M with HTN compared to F and M with normal blood pressure (BP), had a significant decrease in saturation (94,8 (5,0) % vs 95,9 (3,0) %, p = 0,038) and had an increase in the number of individuals with a severe course (11 % vs 4 %, p = 0,041). In 6 M with HTN who survived after COVID-19, atrial fibrillation was registered for the first time. Myocardial repolarization disorders, blockade changes (incomplete right bundle branch block), sinus tachycardia were registered more often in HTN subjects.Conclusions. Thus, our analysis showed that patients with HTN, overweight or obesity were more likely to be infected with COVID-19 under the conditions of the Arctic watch. In 65 % of cases, COVID-19 was accompanied by moderate changes in the lungs of the CT1 type, due to the timely hospitalization of patients. M compared to F more often had a severe course of COVID-19 with a significant decrease in saturation and more frequent electrocardiography changes. Observation and being on a 2-week quarantine before the watch had no significant success in limiting the incidence of COVID-19.