ПРОГНОСТИЧЕСКАЯ МОДЕЛЬ ВЕРОЯТНОСТИ УВЕЛИЧЕНИЯ СТАДИИ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ ПОСЛЕ ВИРУСНОЙ ПНЕВМОНИИ, ВЫЗВАННОЙ SARS-COV-2

Abstract

Abstract. Introduction. An alarming aspect and area of study are represented by the COVID-19 consequences. Arterial hypertension is one of the most frequently reported comorbid pathologies in patients with severe-course COVID-19 requiring the patient’s hospitalization. Given the similarity of some pathogenetic mechanisms underlying arterial hypertension and COVID-19, there is no doubt about their interinfluence. One of the common pathogenetic links of arterial hypertension and COVID-19 is endothelial dysfunction. Objective: To develop a prognostic model of the probability of an increase in the stage of arterial hypertension in 6 months after viral pneumonia caused by SARS-COV-2. Material and Methods: The study included 45 patients with a confirmed diagnosis of COVID-19 (virus identified) with arterial hypertension. This group of patients was dynamically monitored for 6 months after discharge from the hospital. The duration of inpatient treatment was 14 [10-16] bed days. The level of biomarkers of endothelial dysfunction - endothelin-1 and the N-terminal precursor of natriuretic peptide C-type was determined in blood serum by enzyme immunoassay. The dynamics of the levels of these biomarkers during the hospital stay is regarded as positive with a decrease in the level of more than 10% and as insufficient – with an increase, unchanged values or a decrease to 10% inclusive. Results and discussion. The final prognostic model included: the level of the N-terminal precursor of natriuretic peptide C-type upon admission to the hospital and the dynamics of its level in the hospital. The model was statistically significant (p=0,028). Based on the values of regression coefficients, the level of the N-terminal precursor of natriuretic peptide C-type has a direct relationship with the probability of an increase in the stage of arterial hypertension after 6 months in patients with arterial hypertension after viral pneumonia caused by SARS-COV-2. An increase in the level of the N-terminal precursor of natriuretic peptide C-type by 1 pg/ml upon admission increases the risk of an increase in the stage of arterial hypertension by 1,3 times. The absence of positive dynamics of the level of the N-terminal precursor of natriuretic peptide C-type during inpatient treatment increases the likelihood of an increase in the stage of arterial hypertension by 19,6 times. The diagnostic sensitivity of the developed prognostic model was 86,7%, diagnostic specificity – 80,0%, diagnostic efficiency – 84,4%. Conclusions: The prognostic model developed by us, including as a predictor the level of the N-terminal precursor of natriuretic peptide C-type at admission and its dynamics in the hospital, can be used to individually predict an increase in the stage of arterial hypertension within 6 months after viral pneumonia caused by SARS-COV-2.