COVID‐19 and late‐onset hypertension with hyporeninaemic hypoaldosteronism

Mandal, Amit K J; Kho, Jason; Metaxa, Sofia; Missouris, Constantinos G

doi:10.1111/ijcp.13773

Cited by 8 publications

(10 citation statements)

References 4 publications

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“…The complete absence of physical activity and an incorrect diet can cause weight gain and related pathologies. In fact, it has been shown that the lockdown has also led to an increase in diseases such as diabetes and hypertension [33,34].…”

Section: Discussionmentioning

confidence: 99%

Effects of the COVID-19 Pandemic on Job Activity, Dietary Behaviours and Physical Activity Habits of University Population of Naples, Federico II-Italy

Brancaccio

Mennitti

Gentile

et al. 2021

IJERPH

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Coronaviruses (CoVs) are a large family of respiratory viruses that can cause mild to moderate illness. The new variant COVID-19 has started to spread rapidly since December 2019, posing a new threat to global health. To counter the spread of the virus, the Italian government forced the population to close all activities starting from 9 March 2020 to 4 May 2020. In this scenario, we conducted a cross-sectional study on a heterogeneous sample (average age of 28 ± 12 years, 62.6% females) of the University of Naples Federico II (Italy). The aim of the study was to describe the lifestyle change in the university population during quarantine for the COVID 19 pandemic. Participants compiled an online survey consisting of 3 sections: socio-demographic data, dietary behaviours, physical activity habits and psychological aspects. The different results by gender are: 90.8% of females continued to work from home (81.9% were students); 34.8% increased their physical activity; and, only 0.8% prefer ready meals. Whereas, the same percentage of men continued to work from home (90%), but only 72.1% were students (p < 0.001 vs. females), only 23.9% increased physical activity (p < 0.001) and 1.7% favous ready meals. Our data shows that the male population was more affected by isolation and quarantine reporting more unfavourable behavioural changes.

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Section: Discussionmentioning

confidence: 99%

Effects of the COVID-19 Pandemic on Job Activity, Dietary Behaviours and Physical Activity Habits of University Population of Naples, Federico II-Italy

Brancaccio

Mennitti

Gentile

et al. 2021

IJERPH

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“…Given the role of ACE2 and the renin-angiotensin-aldosterone system (RAAS) in COVID-19 [6], the finding of low aldosterone concentration is surprising and in conflict with previous studies that have deployed immunoassays to measure aldosterone in COVID-19 patients. Whilst there are case reports of hyporeninemic hypoaldosteronism in COVID-19 [13] these patients do not generally present with clinical features of hypoaldosteronism, suggesting that despite the lack of correlation between serum aldosterone and cortisol concentration, sufficient mineralocorticoid activity is present to avoid decompensation. Other mechanisms to consider include activation of epithelial sodium channels (ENaC) in the distal nephrons by AngII as opposed to aldosterone, increasing sodium reabsorption and volume expansion (at the cost of potassium and hydrogen ion excretion), which may then provide further negative feedback for RAAS, with associated hyporeninemia and hypoaldosteronism while AngII over-expression continues to be facilitated by ACE2 inhibition.…”

Section: Discussionmentioning

confidence: 96%

Unquantifiably low aldosterone concentrations are prevalent in hospitalised COVID-19 patients but may not be revealed by chemiluminescent immunoassay

Wiegand

Halsall

Cowan

et al. 2022

Endocrine Connections

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Objective: Previous studies have reported conflicting findings regarding aldosterone levels in patients hospitalised with COVID-19. We therefore used the gold-standard technique of liquid chromatography tandem mass-spectrometry (LCMSMS) to address this uncertainty. Design: All patients admitted to Addenbrooke’s Hospital Cambridge with COVID-19 between March 10, 2020 and May 13, 2021, and in whom a stored blood sample was available for analysis, were eligible for inclusion. Methods: Aldosterone was measured by LCMSMS and by immunoassay; cortisol and renin were determined by immunoassay. Results: Using LCMSMS, aldosterone was below the limit of detection (<70 pmol/L) in 74 (58.7%) patients. Importantly, this finding was discordant with results obtained using a commonly employed clinical immunoassay (Liaison Diasorin®), which over-estimated aldosterone compared to the LCMSMS assay (intercept 14.1 [95% CI -34.4 to 54.1] + slope 3.16 [95% CI 2.09 to 4.15] pmol/L). The magnitude of this discrepancy did not clearly correlate with markers of kidney or liver function. Solvent extraction prior to immunoassay improved the agreement between methods (intercept -14.9 [95% CI -31.9 to -4.3] and slope 1.0 [95% CI 0.89 to 1.02] pmol/L) suggesting the presence of a water-soluble metabolite causing interference in the direct immunoassay. We also replicated a previous finding that blood cortisol concentrations were often increased, with increased mortality in the group with serum cortisol levels >744 nmol/L (p=0.005). Conclusion: When measured by LCMSMS, aldosterone was found to be profoundly low in a significant proportion of patients with COVID-19 at the time of hospital admission. This has likely not been detected previously due to high levels of interference with immunoassays in patients with COVID-19, and this merits further prospective investigation.

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“…Proteinuria is also a common manifestation of COVID-19 and is considered a risk factor for a severe disease 5 . New-onset hypertension has also been described in COVID-19 4 . Endothelial dysfunction has been suggested as the mechanism for both manifestations: The SARS-CoV-2 coronavirus accesses host cells via binding to angiotensin-converting enzyme 2, expressed in endothelial cells, and can cause endothelial dysfunction resulting in hypertension, kidney injury and proteinuria, as well as diabetes and thrombosis 8 .…”

Section: Discussionmentioning

confidence: 98%

“…Growing evidence suggests that pregnant patients with coronavirus disease 2019 (COVID-19) infection are at increased risk of severe disease, including intensive care unit (ICU) admission, need for mechanical ventilation and overall mortality, compared with nonpregnant individuals 1,2 . Hypertension, proteinuria and hepatic dysfunction have been described as manifestations of COVID-19 infection [3][4][5] . However, these same findings can also occur in pregnant women that develop preeclampsia, thus creating a diagnostic challenge.…”

Section: Introductionmentioning

confidence: 99%

Preeclampsia-Like Syndrome in a Pregnant Patient With Coronavirus Disease 2019 (COVID-19)

Naeh

Berezowsky

Yudin

et al. 2022

Journal of Obstetrics and Gynaecology Canada

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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COVID‐19 and late‐onset hypertension with hyporeninaemic hypoaldosteronism

Cited by 8 publications

References 4 publications

Effects of the COVID-19 Pandemic on Job Activity, Dietary Behaviours and Physical Activity Habits of University Population of Naples, Federico II-Italy

Effects of the COVID-19 Pandemic on Job Activity, Dietary Behaviours and Physical Activity Habits of University Population of Naples, Federico II-Italy

Unquantifiably low aldosterone concentrations are prevalent in hospitalised COVID-19 patients but may not be revealed by chemiluminescent immunoassay

Preeclampsia-Like Syndrome in a Pregnant Patient With Coronavirus Disease 2019 (COVID-19)

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