Managing hypertension during the COVID-19 pandemic

Nadar, Sunil; Tayebjee, Muzahir H.; Stowasser, Michael; Byrd, James Brian

doi:10.1038/s41371-020-0356-y

Cited by 21 publications

(34 citation statements)

References 19 publications

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“…According to that most cases with hypertension are older than non-hypertension, this makes the condition more complicated and increase the mortality rate. Similar results were seen in other literature reports (10,11).…”

Section: Resultssupporting

confidence: 93%

“…According to the recent study and along with other articles, it was found hypertensive patients with COVID-19 deteriorated faster than patients without hypertension (11). Similar results were seen in previous coronavirus epidemics such as Severe Acute Respiratory Syndrome (SARS) and Middle East respiratory syndrome (MERS) which was shown that hypertension is a risk factor for increased mortality in infected patients (12).…”

Section: Resultssupporting

confidence: 69%

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Survival rate in hypertensive patients with COVID-19

Emami

Javanmardi

Akbari

et al. 2020

Clinical and Experimental Hypertension

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Introduction: A life-threatening respiratory disease, coronavirus 2019 (COVID-19), has spread across the globe since December 2019. Many prognostic factors have already been put forward to predict the risk of death and other outcomes. The current study is evaluating the survival rate between hypertensive and non-hypertensive infected patients. Methods: Patients who were included in this study were admitted between 20 February to 1 March 2020 in Fars (southwest of Iran) province hospitals. Data were collected from the electronic base registry which contained demographic information, medical symptoms, and signs, underlying diseases, CT scan results, and final outcome. Results: Of all 1239 positive cases, 159 (12.83%) had known with hypertension ant this group was significantly older than non-hypertensive patients (66.1 years Vs 48.95 years, p < .001). According to Kaplan-Meier survival curve and log-rank test, it was seen hypertensive patients deteriorated more rapidly than non-hypertensive group (p = .032). Moreover, HIV, cardiovascular, and kidney disease were diagnosed as factors that increase the risk of death in hypertensive patients. Conclusion: The current study about the survival rate of COVID-19 patients had shown hypertensive patents are in danger of disease severity, although it may be related to their age. Moreover, the probability of other complications like diabetes, smoking, asthma, kidney, and cardiovascular diseases, and either some other infections such as HIV can make the condition complicated and need more consideration to prevent noxious outcomes.

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Section: Resultssupporting

confidence: 93%

Section: Resultssupporting

confidence: 69%

Survival rate in hypertensive patients with COVID-19

Emami

Javanmardi

Akbari

et al. 2020

Clinical and Experimental Hypertension

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“…Not only the medications used in COVID-19 management is supposed to affect the cardiovascular status, but also the medications used by CVD patients may affect the COVID-19 susceptibility. For example using different ACE inhibitors or ARBs may cause upregulation of ACE2 receptors ( Wang et al., 2016 ; Kai and Kai, 2020 ) and it is well established that ACE2 is a functional receptor used for entry of the COVID-19 to the cell, and it is supposed that this upregulation worsens the impact of infection ( Nadar et al., 2020 ; Zhou P. et al., 2020 ). Another study supposed that COVID-19 enter the cell via ACE2 receptors but then downregulates it, facilitating neutrophils infiltration, lung injury, and attenuating the cardio protection ( Vaduganathan et al., 2020 ).…”

Section: Genetic/molecular Predisposition and Underlying Conditions Amentioning

confidence: 99%

COVID-19 Genetic and Environmental Risk Factors: A Look at the Evidence

et al. 2020

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The Covid-19 pandemic is with no doubt the biggest health crisis of the 21 st century. The disease is caused by a virus of the Coronaviridae family and is closely related to the virus responsible for the severe acute respiratory Syndrome (SARS). Since December 2019, the virus has continued to spread way beyond the location of the first recorded cases (Wuhan, China). As of now, over 5 million cases have been diagnosed with the disease worldwide and over 300 thousand have died. COVID-19 patients suffer from respiratory symptoms that can rapidly turn into potentially fatal acute respiratory distress syndrome (ARDS) in a portion of patients. Although many drugs and vaccines are currently under clinical trials, there is no currently approved treatment or vaccine. It is therefore critical to correctly identify risk factors that lead to the exacerbation of symptoms in highly susceptible groups. Groups that are at high risk include those aged 55 or older especially those with underlying conditions such as cardiovascular diseases. Certain ethnicities such as African-Americans have been found to be at a higher risk and males seem to be higher both in numbers as well as severity of cases. It is hypothesized that these groups are at risk as their molecular landscape is more permissive of viral infection and growth. Different occupations, especially those related to health-care as well as populations that do not cultivate a mask-wearing culture are at higher risk due to environmental exposure. In this article, we examine the evidence regarding different groups that are more sensitive to the disease and review hypotheses pertaining to COVID-19 infection and prognosis. Risk factors that can be related to the molecular landscape of COVID-19 infection as well as those related to environmental and occupational conditions are discussed.

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“…Patients with acute or chronic cardiovascular diseases (CVD) encountered difficulties during this historical pandemic ( 6 – 9 ). Actually, a significant reduction of patient admissions due to different types of CVDs was observed ( 10 – 13 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of the 2019 Novel Coronavirus Disease Pandemic on the Performance of a Cardiovascular Department in a Non-epidemic Center in Beijing, China

Jiang

Zhang

Tian

et al. 2021

Front. Cardiovasc. Med.

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Background: Knowledge of the impact of the 2019 novel coronavirus disease (COVID-19) pandemic on the performance of a cardiovascular department in a medical referral hub center from a non-epidemic area of China is limited.Method: The data on the total number of non-emergency medical cares (including the number of out-patient clinic attendances, the number of patients who were hospitalized in non-intensive care wards, and patients who underwent elective cardiac intervention procedures) and emergency medical cares [including the number of emergency department (ED attendances) and chest pain center (CPC attendances), as well as the number of patients who were hospitalized in coronary care unit (CCU) and the number of patients who underwent emergency cardiac intervention procedures] before and during the pandemic (time before the pandemic: 20th January 2019 to 31st March 2019 and time during the pandemic: 20th January 2020 to 31st March 2020) in the Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University were collected and compared.Results: Both the non-emergency medical and emergency medical cares were affected by the pandemic. The total number of out-patient clinic attendance decreased by 44.8% and the total number of patients who were hospitalized in non-intensive care wards decreased by 56.4%. Pearson correlation analysis showed that the number of out-patient clinic attendance per day was not associated with the number of new confirmed COVID-19 cases and the cumulative number of confirmed COVID-19 patients in Beijing (r = −0.080, p = 0.506 and r = −0.071, p = 0.552, respectively). The total number of patients who underwent non-emergency cardiac intervention procedures decreased during the pandemic, although there were no statistically significant differences except for patent foramen ovale (PFO) occlusion (1.7 ± 2.9 vs. 8.3 ± 2.3, p = 0.035). As for the emergency medical cares, the ED attendances decreased by 22.4%, the total number of CPC attendances increased by 10.3%, and the number of patients who were hospitalized in CCU increased by 8.9%: these differences were not statistically significant. During the pandemic, the proportion of hospitalized patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) significantly increased (19.0 vs. 8.7%, p < 0.001; 28.8 vs. 18.0%, p < 0.001, respectively); also, the number of primary percutaneous coronary intervention (PCI) increased by 10.3%. There was no significant difference between patients before and during the pandemic regarding the age, gender, baseline and discharge medication therapy, as well as length of stay and in-hospital mortality.Conclusions: Our preliminary results demonstrate that both the non-emergency and emergency medical cares were affected by the COVID-19 pandemic even in a referral medical center with low cross-infection risk. The number of the out-patient clinic attendances not associated with the number of confirmed COVID-19 cases could be due to different factors, such as the local government contamination measures. The proportion of hospitalized patients with acute myocardial infarction increased in our center during the pandemic since other hospitals stopped performing primary angioplasty. A hub-and-spoke model could be effective in limiting the collateral damage for patients affected by cardiovascular diseases when the medical system is stressed by disasters, such as COVID-19 pandemic.

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Managing hypertension during the COVID-19 pandemic

Cited by 21 publications

References 19 publications

Survival rate in hypertensive patients with COVID-19

Survival rate in hypertensive patients with COVID-19

COVID-19 Genetic and Environmental Risk Factors: A Look at the Evidence

Impact of the 2019 Novel Coronavirus Disease Pandemic on the Performance of a Cardiovascular Department in a Non-epidemic Center in Beijing, China

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