ANALYSIS OF CARDIOVASCULAR RISK COMPONENTS IN THE COMORBID COURSE OF COMMUNITY-ACQUIRED PNEUMONIA ASSOCIATED WITH COVID-19 AND ARTERIAL HYPERTENSION
DOI:
https://doi.org/10.32782/health-2024.2.13Keywords:
pneumonia, COVID-19, hypertension, diabetes, obesity, cardiovascular diseases, age, risk.Abstract
The aim of the study was to establish the level of cardiovascular risk based on the analysis of its components in patients with COVID-19 associated community-acquired pneumonia (CAP) and comorbid course with arterial hypertension (AH). To address the goal, a retrospective study of the medical records of 191 patients with CAP was conducted, in which the epidemiological history of SARS-CoV-2 infection was established with the identification of SARS-CoV-2 nucleic acid in swabs from the throat or lower respiratory tract using real-time polymerase chain reaction later than 1 month before admission to inpatient treatment. The characteristics of the age distribution of patients with CAP in COVID-19 depending on the presence of AH and age (≥55 years in men and ≥65 years in women) indicate the probable influence of age on the comorbid course of the studied pathologies. Thus, the percentage of patients with CAP and AH with this cardiovascular risk was probably higher in all studied groups, respectively, in relation to the percentage of age-matched patients without AH. Analysis of the presence/absence of obesity, diabetes, coronary heart disease, and dyslipidemia as markers of cardiovascular risk in patients with COVID-19-associated pneumonia showed that both among patients with comorbid hypertension and without it, the percentage of individuals with cardiovascular risks were lower. The study of such markers of cardiometabolic risk as the presence of chronic kidney disease and smoking did not show their probable association both with the severity of COVID-19-associated CAP, and did not affect the comorbid course with AH. The comorbid course of COVID-19-associated community-acquired pneumonia and arterial hypertension is accompanied by almost equally high and very high cardiovascular risk regardless of the severity of pneumonia, largely due to age, heart failure, and peripheral vascular disease, while patients without concomitant arterial hypertension are diagnosed with moderate cardiovascular risk.
References
Коронавірус: статистика по країнах. Мінфін. URL: https://index.minfin.com.ua/ua/reference/coronavirus/geography/ (дата звернення: 01.04.2024).
Guo T., Fan Y., Chen M., Wu X., Zhang L., He T., et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020. № 5. Р. 811–818. doi: 10.1001/jamacardio.2020.1017
Shi S., Qin M., Shen B., Cai Y., Liu T., Yang F., et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020. № 5. Р. 802–810. doi: 10.1001/jamacardio.2020.0950
Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020. № 14. Р. 247–250. doi: 10.1016/j.dsx.2020.03.013
Tajbakhsh A., Gheibi Hayat S. M., Taghizadeh H., Akbari A., Inabadi M., Savardashtaki A., et al. COVID-19 and cardiac injury: clinical manifestations, biomarkers, mechanisms, diagnosis, treatment, and follow up. Expert Rev Anti-Infect Ther. 2021. № 19. Р. 345–357. doi: 10.1080/14787210.2020.1822737
Babapoor-Farrokhran S., Gill D., Walker J., Rasekhi R. T., Bozorgnia B., Amanullah A. Myocardial injury and COVID-19: possible mechanisms. Life Sci. 2020. № 253. Р. 117723. doi: 10.1016/j.lfs.2020.117723
Vasudeva R., Challa A., Al Rifai M., Polana T., Duran B., Vindhyal M., et al. Prevalence of cardiovascular diseases in COVID-19 related mortality in the United States. Prog Cardiovasc Dis. 2022. № 74. Р. 122–126. doi: 10.1016/j.pcad.2022.09.002
Grasselli G., Zangrillo A., Zanella A., Antonelli M., Cabrini L., Castelli A., et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA. 2020. № 323. Р. 1574–1581. doi: 10.1001/jama.2020.5394
Guzik T. J., Mohiddin S. A., Dimarco A., Patel V., Savvatis K., Marelli-Berg F. M., et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020. № 116. Р. 1666–1687. doi: 10.1093/cvr/cvaa106.
Ayoubkhani D., Khunti K., Nafilyan V., Maddox T., Humberstone B., Diamond I., et al. Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study. BMJ. 2021. № 372. Р. сn693.
Daugherty S. E., Guo Y., Heath K., Dasmariñas M. C., Jubilo K. G., Samranvedhya J., et al. Risk of clinical sequelae after the acute phase of SARS-CoV-2 infection: retrospective cohort study. BMJ. 2021. № 373. Р. n1098.
Xie Y., Xu E., Bowe B., Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022. № 28. Р. 583–590.
Woodhead M., Blasi F., Ewig S., Garau J., Huchon G., Ieven M., at. al. Guidelines for the management of adult lower respiratory tract infections--full version. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2011. № 17. Suppl 6. Р. E1–E59. https://doi.org/10.1111/j.1469-0691.2011.03672.x
Pneumonia in adults: diagnosis and management. NICE Clinical Guideline (CG 191). URL: https://www.nice.org.uk/guidance/cg191 (date of access: 30.03.2024).
Williams B., Mancia G., Spiering W., Agabiti Rosei E., Azizi M., Burnier M., at. al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. European heart journal. 2018. № 39(33). Р. 3021–3104. https://doi.org/10.1093/eurheartj/ehy339
Henry B. M., de Oliveira M. H. S., Benoit S., Plebani M., Lippi, G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clinical chemistry and laboratory medicine. 2020. № 58(7). Р. 1021–1028. https://doi.org/10.1515/cclm-2020-0369
Kjeldsen S. E. Hypertension and cardiovascular risk: General aspects. Pharmacological research. 2018. № 129. Р. 95–99. https://doi.org/10.1016/j.phrs.2017.11.003
Raisi-Estabragh Z., Cooper J., Salih A., Raman B., Lee A. M., Neubauer S., et al. Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank. Heart. 2022. № 109. Р. 119–126.
Wang W., Wang C. Y., Wang S. I., Wei J. C. Long-term cardiovascular outcomes in COVID-19 survivors among nonvaccinated population: a retrospective cohort study from the TriNetX US collaborative networks. EClinicalMedicine. 2022. № 53. Р. 101619.
Jin Y., Ji W., Yang H., Chen S., Zhang W., Duan G. Endothelial activation and dysfunction in COVID-19: from basic mechanisms to potential therapeutic approaches. Signal Transduct Target Ther. 2020. № 5. Р. 293.
Varga Z., Flammer A. J., Steiger P., Haberecker M., Andermatt R., Zinkernagel A. S., et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020. № 395. Р. 1417–1418.
Farshidfar F., Koleini N., Ardehali H. Cardiovascular complications of COVID-19. JCI Insight. 2021. № 6. Р. e148980.
Andrade Silva M., da Silva A. R. P. A., do Amaral M. A., Fragas M. G., Câmara N. O. S. Metabolic alterations in SARS-CoV-2 infection and its implication in kidney dysfunction. Front Physiol. 2021. № 12. Р. 624698.
Schoene D., Schnekenberg L. G., Pallesen L. P., Barlinn J., Puetz V., Barlinn K., et al. Pathophysiology of cardiac injury in COVID‐19 patients with acute ischaemic stroke: what do we know so far?‐a review of the current literature. Life (Basel). 2022. № 12. Р. 12.
Elseidy S. A., Awad A. K., Vorla M., Fatima A., Elbadawy M. A., Mandal D., et al. Cardiovascular complications in the post‐acute COVID‐19 syndrome (PACS). Int J Cardiol Heart Vasc. 2022. № 40. Р. 101012.
Bojkova D., Wagner J. U. G., Shumliakivska M., Aslan G. S., Saleem U., Hansen A., et al. SARS‐CoV‐2 infects and induces cytotoxic effects in human cardiomyocytes. Cardiovasc Res. 2020. № 116. Р. 2207–2215.
Patel V. B., Zhong J. C., Grant M. B., Oudit G. Y. Role of the ACE2/angiotensin 1‐7 Axis of the renin‐angiotensin system in heart failure. Circ Res. 2016. № 118. Р. 1313–1326.
Schoene D., Schnekenberg L. G., Pallesen L. P., Barlinn J., Puetz V., Barlinn K., et al. Pathophysiology of cardiac injury in COVID‐19 patients with acute ischaemic stroke: what do we know so far?‐a review of the current literature. Life (Basel). 2022. № 12. Р. 12.
Chang W. T., Toh H. S., Liao C. T., Yu W. L. Cardiac involvement of COVID‐19: a comprehensive review. Am J Med Sci. 2021. № 361. Р. 14–22.
