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高血压合并症对感染野生型、德尔塔或奥密克戎变异株严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的2019冠状病毒病(COVID-19)患者临床特征的影响

Effect of Hypertension Comorbidity on Clinical Characteristics of COVID-19 Patients Infected by the Wild-Type, the Delta or Omicron Variant SARS-CoV-2.

作者信息

Zhang Jinhui, Zhang Jianguo, Tao Zhimin

机构信息

Department of Emergency Medicine, The Affiliated Hospital, Jiangsu University, 212001 Zhenjiang, Jiangsu, China.

Department of Critical Care Medicine, The Affiliated Hospital, Jiangsu University, 212001 Zhenjiang, Jiangsu, China.

出版信息

Rev Cardiovasc Med. 2022 Dec 2;23(12):395. doi: 10.31083/j.rcm2312395. eCollection 2022 Dec.

Abstract

BACKGROUND

Hypertension was the most common comorbidity in patients with the coronavirus disease 2019 (COVID-19). We aim to study the effect of comorbid hypertension on the clinical characteristics of COVID-19 patients with the underlying mechanism.

METHODS

We retrospectively analyzed 459, 336 and 659 COVID-19 patients who were infected by the wild-type, the delta and omicron variant, respectively, including their demographic information, medical history, immunization record (if available), and laboratory parameters, to investigate the clinical differences between COVID-19 patients with and without hypertension.

RESULTS

In this study 26.1%, 26.8%, and 12.9% of COVID-19 patients had pre-existing hypertension in the cohort of wild-type, delta, and omicron variant, respectively. Compared to non-hypertensive peers, hypertension patients demonstrated older age, higher occurrence of other major comorbidities, and poorer blood or coagulation parameters, showing worse prognosis. In case of the delta or omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, hypertension patients produced robust antibody responses, although indistinguishable whether it was due to vaccination or natural infection and resembled those of non-hypertensive peers in blood cell and coagulation profiles with still varying viremic damages to major organs.

CONCLUSIONS

Resultantly, COVID-19 infection promoted pro-inflammatory and pro-thrombotic states in hypertension patients, whereas vaccinated individuals would exhibit favorable prognoses.

摘要

背景

高血压是2019冠状病毒病(COVID-19)患者中最常见的合并症。我们旨在研究合并高血压对COVID-19患者临床特征的影响及其潜在机制。

方法

我们回顾性分析了分别感染野生型、德尔塔和奥密克戎变异株的459例、336例和659例COVID-19患者,包括他们的人口统计学信息、病史、免疫记录(如有)和实验室参数,以调查合并高血压和未合并高血压的COVID-19患者之间的临床差异。

结果

在本研究中,野生型、德尔塔和奥密克戎变异株队列中分别有26.1%、26.8%和12.9%的COVID-19患者患有高血压。与非高血压患者相比,高血压患者年龄更大,其他主要合并症的发生率更高,血液或凝血参数更差,预后更差。在感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的德尔塔或奥密克戎变异株的情况下,高血压患者产生了强烈的抗体反应,尽管无法区分这是由于接种疫苗还是自然感染,并且在血细胞和凝血谱方面与非高血压患者相似,但对主要器官的病毒血症损伤仍有所不同。

结论

因此,COVID-19感染在高血压患者中促进了促炎和促血栓形成状态,而接种疫苗的个体预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04c6/11270381/c71f4bef1d29/2153-8174-23-12-395-g1.jpg

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