Clinical and laboratory criteries of severe course of COVID-19 patients with concomitant arterial hypertension

Coronavirus infection CoronaVirus Disease-2019 (CVI, COVID-19) continues to be one of the most common and requires further study of infectious diseases. In combination with another common medical and social pathology, arterial hypertension (AH), the course of COVID-19 is characterized by severe course and high mortality. Based on the results of scientific research, a significant evidence base has been accumulated for early diagnosis and prediction of the course of COVID19. Objective: To describe the clinical and laboratory picture and risk factors for an unfavorable course of coronavirus infection COVID-19 in patients with concomitant arterial hypertension. The authors studied the medical histories of patients (n=200) with COVID-19 of varying severity with arterial hypertension who were hospitalized in the infectious diseases department of the Yakutsk Republic Clinical Hospital in the period 2020–2022. In patients with COVID-19 in combination with hypertension in severe forms of the disease, the following clinical manifestations were most often established: fever (79.7 %), general weakness (82.1 %), cough (62.5 %) and shortness of breath (62.6 %). Severe course of COVID-19 was significantly more often observed in the studied patients with grade 3 obesity (p=0.023) and type 2 diabetes mellitus (p=0.05). In severe course of COVID-19, in laboratory parameters at the time of admission, statistically significant increase in ALT, AST and NT-proBNP levels (p<0.05) are noteworthy, as well as significant violation of lipid profile parameters (p<0.05). The probability of a severe course of COVID-19 in individuals with hypertension is indicated by the high mortality rate, which amounted to 32.5 % (p<0.001) in severe forms. Conclusion: The most common clinical manifestations of COVID-19 in severe patients with hypertension are fever, general weakness, cough and shortness of breath. Regardless of age, for individuals with hypertension, COVID-19 occurs in a severe form with the development of complications in the presence of obesity and type 2 diabetes. Elevated levels of natriuretic peptide (NTproBNP), ALT, AST, LDL-C at the time of hospitalization can be a predictor of a severe course of COVID-19 in patients with hypertension. A fatal outcome in severe COVID-19 developed in 32.5 % of the cases.

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