Lviv clinical bulletin 2022, 1(37)-2(38): 75-80

https://doi.org/10.25040/lkv2022.01-02.075

Peculiarities of Arterial Hypertension Course in Patients with Concomitant Diabetes Mellitus in the Post-COVID Period

Posted onAuthorAdminЗалишити коментар / Leave a comment

O. Voloshyna, V. Zbitneva, E. Zubok, I. Balashova, I. Lysyi, О. Dukova, A. Voloshyn, О.  Chekhlova

Odessa National Medical University

Introduction. Recent publications indicate that the most common comorbidities in hospitalized patients with coronavirus infection were arterial hypertension (AH), diabetes mellitus (DM), and coronary heart disease. However, the peculiarities of AH course in post-COVID-19 patients, especially with concomitant DM, are insufficiently covered in the relevant literature.

The aim of the study. Тo investigate the peculiarities of hypertension course in patients with concomitant diabetes mellitus previously affected with COVID-19 infection.

Materials and methods. We examined 48 patients with essential hypertension of stage II-III of 1-3 degrees, and concomitant DM, previously affected with Covid-19, 52-72 years of age.

Results. It has been estimated that more than 1/3 of patients with hypertension who relapsed to COVID-19 complained of frequent headaches, palpitations, coughs, muscle and joint pain, fatigue and sleep disturbances. However, patients with concomitant DM were significantly more likely to complain of general weakness and indigestion. In many patients, regardless of the presence of concomitant pathology, in the postcocious period there was indicated an increase in C-reactive protein more than 3 mg/l and enhanced fibrinogen levels, indicating an increased risk of cardiovascular complications in this group patients. Most patients experienced worsening of blood pressure control during COVID-19 treatment. Uncontrolled hypertension was significantly more common in patients hospitalized for the treatment of acute COVID-19, regardless of DM presence.

Conclusions. In patients with AH and concomitant DM significantly more often (76.0 % of cases (p = 0.01)) – compared to patients with AH without DM (60.9 %) was detected  uncontrolled hypertension in the post-COVID period. Worsening of blood pressure control in patients with concomitant DM is significantly more common (p < 0.001) in those patients who took three or more antihypertensive drugs, this notion require additional correction of antihypertensive therapy.

References

  1. Buheruk VV, Voloshyna OB, Balashova IV. Inflammatory myocardial damage in patients with coronavirus disease 2019. Zaporozhye Medical Journal. 2021;23(4):555-566 (Ukrainian)
  2. Zbitnieva VO, Voloshyna OB, Balashova IV, Dukova OR, Lysiy IS. Incidence of cardiac arrhythmias in patients with COVID-19 infection according to daily electrocardiogram monitoring. Zaporozhye Medical Journal. 2021;23(6):759-765 (Ukrainian)
  3. Romakin BB. Computer data analysis. Tutorial. Mykolaiv: MSU named after Petra Mogili; 2006. 144 p. (Ukrainian)
  4. Augustin M, Shommers P, Stecher M et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. J Research Paper. 2021;6:100-122.
  5. Batlle D, Wysocki J, Satchell K. Soluble angiotensin-converting enzyme 2: a potential approach for coronavirus infection therapy? ClinSci (Lond). 2020;134:543-545.
  6. Cyril P. Landstra, Eelco JP de Koning. COVID-19 and Diabetes: Understanding the Interrelationship and Risks for a Severe Course. Endocrinol [Internet]. 2021 June 17 [cited 2021 Dec 19]. Available from: https://doi.org/10.3389/fendo.2021.649525.
  7. 2018 ESC/ESH Clinical Practice Guidelines for the Management of Arterial Hypertension. European Society of Cardiology [Internet]. 2018 [cited 2022 Jan 21]. Available from: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ Arterial-Hypertension-Management-of.
  8. Holt RIG,DeVries JH, Hess-Fischl A et al. The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care [Internet]. 2021 October 11 [cited 2021 Dec 29]. Available from: DOI: 10.2337/dci21-0043.
  9. Phadke M, Saunik S. Rapid response: use of angiotensin receptor blockers such as Telmisartan, Losartsan in nCoV Wuhan Corona Virus infections-novel mode of treatment. Response to the emerging novel coronavirus outbreak. Br Med J. 2020;368:406.
  10. Shiffrin EL, Flack GM, Ito S et al. Hypertension and COVID-19 . American Journal of Hypertension [Internet]. 2020 May [cited 2021 Dec 24]; 33(5):373–374. Available from: https://doi.org/10.1093/ajh/hpaa057.
  11. Wu C, Chen X, Cai Y et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med [Internet]. 2020 March 13 [cited 2022 Jan 16]. Available from: doi:1001/jamainternmed.2020.0994.