Blood pressure level and laboratory indicators of disease severity in patients with arterial hypertension and COVID-19

Abstract

Funding AcknowledgementsType of funding sources: None.Background.Many patients with COVID-19 suffer from arterial hypertension and have marked variations in blood pressure (BP) during the acute period of infection. The reasons for such changes are poorly understood.Purpose.To assess the relationship between the level of BP and the severity of changes in the main clinical and laboratory parameters in patients with arterial hypertension and with a moderate course of COVID-19 at the stage of the height of the disease.Materials and methods.The study included 86 hospitalized patients with verified coronavirus disease of moderate severity: 46 of them were male, the median age was 65 years. Patients received adequate hypertension therapy for a long time. After hospitalization, treatment was adjusted if necessary. The level of laboratory parameters in the acute period of the disease was determined, including the electrolytes, C-reactive protein (CRP), albumin, ferritin, general blood test, etc. BP measured daily. The relationship between laboratory parameters and BP level was evaluated by nonparametric correlation using the Spearman coefficient and multivariate analysis based on the "generalized nonlinear model".Results.In 67.44% of patients with hypertension, an elevated BP level (>140/90) was observed against the background of moderate COVID-19. There was a significant negative correlation between the levels of CRP and BP throughout the stay in the hospital, the most significant is the 5th day of hospitalization. At the same time, a slightly stronger relationship is observed with diastolic BP (r = -0.4425) than with systolic BP (r = -0.3525). A similar trend is observed in all BP measurements. Besides, a negative correlation was found between potassium levels and BP values. The strongest association of potassium levels is with systolic BP on the day of hospitalization (r = -0.4850) and diastolic pressure on the 1st day of hospitalization (r = -0.3561). Multivariate analysis confirmed independent and reliable "influence" of CRP (p = 0.00018) and potassium (p = 0.03921) as independent predictors of diastolic pressure.Conclusions.Most patients with hypertension and moderate COVID-19 have elevated BP levels. There is a statistically significant negative relationship between the values of BP and levels of CRP and potassium. The obtained data may correspond to the existing hypothesis about the significant role of the kinin–kallikrein system in the pathogenesis of COVID-19.