Markers of acute inflammation in patients with COVID-19 in combination with hypertension

• Victoria V. Kiseleva
• Kirill S. Yachmenev
• Lyudmila Yu. Zaitseva

Abstract

Hypertension is the most common concomitant disease in COVID-19. Although the increased mortality from a new coronavirus infection occurring against the background of concomitant hypertension has been proven many times, the greater problem is the search for prognostic factors that would allow predicting the risk of severe infection caused by SARS-CoV-2 and death at an early stage.

The aim of the study was to determine the level of some markers of acute inflammation (ferritin, C-reactive protein, IL-6) in patients with a new coronavirus infection combined with hypertension.

Material and methods. The study included 130 patients of two groups: the main group - patients with COVID-19, occurring against the background of hypertension (n=70), the control group - patients with COVID-19 of moderate severity without concomitant diseases (n=60). Criteria for inclusion in the main group: the presence of stage II hypertension (drug-controlled) and the absence of additional concomitant diseases, including severe obesity ≥II degrees (body mass index ≥35 kg/m²). Patients of the main group by age (from 38 to 65 years, average age 57.0±6.9 years) did not differ from patients of the control group (from 42 to 65 years, average age 53.6±6.6 years). Women prevailed in both groups - 61.4% in the main group and 70% in the control group, respectively. The criteria for excluding patients were: BDD no more than 30/min, SpO₂ no lower than 93%, absence of a positive result of a study on SARS-CoV-2 RNA by PCR from the nasopharynx and oropharynx, CT changes characteristic of a viral lesion involving more than 50% of lung parenchyma (CT 3-4), IL-6 levels over 40 pg/ml, age over 65 years.

Results. The ferritin index above 500 ng/ml was in 30% of patients of the main and 23.3% of the control group. Comparison of ferritin levels in the two groups showed that its indicators in patients of the main group were significantly higher than those of the control group (p=0.033; p<0.05). C-reactive protein (CRP) was also more often elevated in patients of the main group with arterial hypertension than in patients without a history of hypertension (55.7±5.1 and 45.3±4.6 mg/l, respectively), but the difference in the degree of its increase was not significant (p=0.132; p>0.05). The average value of IL-6 in both groups was within normal values: 8.9±1.2 pg/ml in the main group and 5.6±1.1 pg/ml in the control group (p=0.045; p<0.05).

Conclusion. In patients with COVID-19, which occurred against the background of hypertension, there was a significant increase in the level of a number of markers of acute inflammation (ferritin, IL-6) compared with patients without concomitant hypertension. These changes may be associated with the effect of high blood pressure on the vascular wall, as well as with the tropicity of the virus to vascular endothelial cells.

Keywords:COVID-19, hypertension, markers of inflammation, ferritin

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