Interactions between hypertension and inflammatory tone and the effect on blood pressure and outcomes in patients with COVID-19.
Arterial hypertension represented one of the most common comorbidities in patients with COVID-19. However, the impact of hypertension on outcome in COVID-19 patients is not clear. Close connections between inflammation and blood pressure (BP) have been described, and inflammation plays a key role in the outcome for patients with COVID-19. Whether hypertension impairs the relationship between inflammation, BP, and outcomes in this context is not known. The aim of this study was to examine the effects of the interactions between inflammation and hypertension status on BP and clinical outcome in patients hospitalized with COVID-19. We designed a retrospective study in 129 patients hospitalized with COVID-19 at Toulouse University Hospital. The hospital outcome was admission to the intensive care unit or death. The inflammatory markers were blood C-reactive protein level (CRP), neutrophil to lymphocyte, and platelet to lymphocyte ratios. We identified strong correlations between CRP (P < .01) and the other inflammatory markers recorded on admission (P < .001) with mean BP within 3 days after admission in normotensive patients, whereas these correlations were absent in patients with hypertension. Also, we observed after multivariate adjustment (P < .05) that CRP level predicted a worse prognosis in hypertensive patients (relative risk 2.52; 95% confidence intervals [1.03- 6.17]; P = .04), whereas CRP was not predictive of outcome in patients without hypertension. In conclusion, the study revealed that in COVID-19 patients, hypertension impairs the relationship between inflammation and BP and interacts with inflammation to affect prognosis. These findings provide insights that could explain the relationship between hypertension and outcomes in COVID-19 patients.
['Amar|Jacques|J|0000-0001-9629-9446', 'Touront|Nicolas|N|', 'Ciron|Antoine M|AM|', 'Pendaries|Caroline|C|']
D000328:Adult D015415:Biomarkers D001794:Blood Pressure D002097:C-Reactive Protein D000086382:COVID-19 D016022:Case-Control Studies D005260:Female D005602:France D006760:Hospitalization D006801:Humans D006973:Hypertension D018836:Inflammation Mediators D008297:Male D011379:Prognosis D012189:Retrospective Studies D000086402:SARS-CoV-2
hypertension COVID-19 inflammation C-reactive protein