The Renin–Angiotensin-Aldosterone System, Nitric Oxide, and Hydrogen Sulfide at the Crossroads of Hypertension and COVID-19: Racial Disparities and Outcomes

Ranjbar, Tara; Oza, Palak P.; Kashfi, Khosrow

doi:10.3390/ijms232213895

Cited by 4 publications

(2 citation statements)

References 185 publications

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“…Persistent activation of RAAS and endothelial injury have been reported among patients with COVID-19 and both are associated with blood pressure elevation. 25,26 In addition, consequences of severe COVID-19 including systemic hypoxia, acute respiratory distress, hypercoagulation, sepsis, inflammation, metabolic stress, and cytokine storm may stress the cardiovascular system that could lead to blood pressure dysregulation. 2,[8][9][10][11] Acute kidney injury (AKI), a common complication among hospitalized patients with COVID-19, 3,4,27,28 may also lead to new-onset hypertension secondary to fluid retention.…”

Section: Possible Mechanismsmentioning

confidence: 99%

Incidence of New-Onset Hypertension Post–COVID-19: Comparison With Influenza

Zhang,

Fisher,

Hou

et al. 2023

Hypertension

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BACKGROUND: SARS-CoV-2 may trigger new-onset persistent hypertension. This study investigated the incidence and risk factors associated with new-onset persistent hypertension during COVID-19 hospitalization and at ≈6-month follow-up compared with influenza. METHODS: This retrospective observational study was conducted in a major academic health system in New York City. Participants included 45 398 patients with COVID-19 (March 2020 to August 2022) and 13 864 influenza patients (January 2018 to August 2022) without a history of hypertension. RESULTS: At 6-month follow-up, new-onset persistent hypertension was seen in 20.6% of hospitalized patients with COVID-19 and 10.85% of nonhospitalized patients with COVID-19. Persistent hypertension incidence among hospitalized patients did not vary across the pandemic, whereas that of among hospitalized patients decreased from 20% in March 2020 to ≈10% in October 2020 (R 2 =0.79, P =0.003) and then plateaued thereafter. Hospitalized patients with COVID-19 were 2.23 ([95% CI, 1.48–3.54]; P <0.001) times and nonhospitalized patients with COVID-19 were 1.52 ([95% CI, 1.22–1.90]; P <0.01) times more likely to develop persistent hypertension than influenza counterparts. Persistent hypertension was more common among older adults, males, patients with preexisting comorbidities (chronic obstructive pulmonary disease, coronary artery disease, chronic kidney disease), and those who were treated with pressor and corticosteroid medications. Mathematical models predicted persistent hypertension with 79% to 86% accuracy. In addition, 21.0% of hospitalized patients with COVID-19 with no prior hypertension developed hypertension during COVID-19 hospitalization. CONCLUSIONS: Incidence of new-onset persistent hypertension in patients with COVID-19 is higher than those with influenza, likely constituting a major health burden given the sheer number of patients with COVID-19. Screening at-risk patients for hypertension following COVID-19 illness may be warranted.

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Section: Possible Mechanismsmentioning

confidence: 99%

Incidence of New-Onset Hypertension Post–COVID-19: Comparison With Influenza

Zhang,

Fisher,

Hou

et al. 2023

Hypertension

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“…The importance of NO in the pathogenesis of COVID-19 was elucidated in a review by Ranjbar et al [ 139 ]. NO is a vasodilator produced by endothelial cells which could potentially be used to treat COVID-19.…”

Section: Identification Of Covid-19-specific Chemical Biomarkersmentioning

confidence: 99%

Potential for Early Noninvasive COVID-19 Detection Using Electronic-Nose Technologies and Disease-Specific VOC Metabolic Biomarkers

Wilson

Forse

2023

Sensors

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The established efficacy of electronic volatile organic compound (VOC) detection technologies as diagnostic tools for noninvasive early detection of COVID-19 and related coronaviruses has been demonstrated from multiple studies using a variety of experimental and commercial electronic devices capable of detecting precise mixtures of VOC emissions in human breath. The activities of numerous global research teams, developing novel electronic-nose (e-nose) devices and diagnostic methods, have generated empirical laboratory and clinical trial test results based on the detection of different types of host VOC-biomarker metabolites from specific chemical classes. COVID-19-specific volatile biomarkers are derived from disease-induced changes in host metabolic pathways by SARS-CoV-2 viral pathogenesis. The unique mechanisms proposed from recent researchers to explain how COVID-19 causes damage to multiple organ systems throughout the body are associated with unique symptom combinations, cytokine storms and physiological cascades that disrupt normal biochemical processes through gene dysregulation to generate disease-specific VOC metabolites targeted for e-nose detection. This paper reviewed recent methods and applications of e-nose and related VOC-detection devices for early, noninvasive diagnosis of SARS-CoV-2 infections. In addition, metabolomic (quantitative) COVID-19 disease-specific chemical biomarkers, consisting of host-derived VOCs identified from exhaled breath of patients, were summarized as possible sources of volatile metabolic biomarkers useful for confirming and supporting e-nose diagnoses.

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Patients with type 1 diabetes are at elevated risk of developing new hypertension, chronic kidney disease and diabetic ketoacidosis after COVID‐19: Up to 40 months’ follow‐up

Mehrotra‐Varma,

Lu,

Boparai

et al. 2024

Diabetes Obesity Metabolism

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AimThe aim was to investigate whether COVID‐19 increases new incidence of hypertension (HTN), chronic kidney disease (CKD) and diabetic ketoacidosis (DKA) in patients with type 1 diabetes (T1D) up to 40 months post‐infection.Materials and MethodsThree groups of patients from the Montefiore Health System in the Bronx (1 March 2020 to 1 July 2023) were studied: T1D patients hospitalized for COVID‐19 (H‐COVID‐19, n = 511), T1D patients with COVID‐19 but not hospitalized for COVID‐19 (NH‐COVID‐19, n = 306) and T1D patients without a positive COVID‐19 test on record (non‐COVID‐19, n = 1547). COVID‐19 patients were those with a positive polymerase‐chain‐reaction test on record, and non‐COVID‐19 patients were either tested negative or not tested on record. Cumulative incidences and adjusted hazard ratios (aHR) with 95% confidence intervals (CI) were computed with adjustment for competing risks.ResultsCompared to non‐COVID‐19 patients, both H‐COVID‐19 (unadjusted 19.72% vs. 3.14%, p < 0.001; aHR = 7.55 [3.33, 17.06], p < 0.001) and NH‐COVID‐19 (10.26% vs. 3.14%, p = 0.004; aHR = 5.08 [2.19, 11.78], p < 0.001) patients were more likely to develop new HTN. Compared to non‐COVID‐19 patients, both H‐COVID‐19 (11.41% vs. 1.14%, p < 0.001; aHR = 9.76 [4.248, 22.25], p < 0.001) and NH‐COVID‐19 (7.69% vs. 1.14%, p < 0.001; aHR = 6.54 [2.91, 14.67], p < 0.001) patients were more likely to develop new CKD. Compared to non‐COVID‐19 patients, both H‐COVID‐19 (4.09% vs. 1.06%, p < 0.001; aHR = 12.24 [4.09, 36.59], p < 0.001) and NH‐COVID‐19 (3.06% vs. 1.06%, p = 0.035; aHR = 12.94 [4.09, 40.89], p < 0.001) patients were more likely to develop new DKA at follow‐up.ConclusionT1D patients with COVID‐19 are at higher risk of developing new HTN, CKD and DKA compared to T1D patients without COVID‐19.

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The Renin–Angiotensin-Aldosterone System, Nitric Oxide, and Hydrogen Sulfide at the Crossroads of Hypertension and COVID-19: Racial Disparities and Outcomes

Cited by 4 publications

References 185 publications

Incidence of New-Onset Hypertension Post–COVID-19: Comparison With Influenza

Incidence of New-Onset Hypertension Post–COVID-19: Comparison With Influenza

Potential for Early Noninvasive COVID-19 Detection Using Electronic-Nose Technologies and Disease-Specific VOC Metabolic Biomarkers

Patients with type 1 diabetes are at elevated risk of developing new hypertension, chronic kidney disease and diabetic ketoacidosis after COVID‐19: Up to 40 months’ follow‐up

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