FEATURES OF THE COURSE OF ARTERIAL HYPERTENSION IN PATIENTS AFTER COVID-19
Authors: Koval Sergiy , Rieznik Larysa , Penkova Maryna , Konkova Viktoria 
Published: December 2022

Introduction. Arterial hypertension (AH) is one of the most common comorbidities in patients with COVID-19. A number of studies have revealed a more severe course of COVID-19 (coronavirus disease (CVD) in patients with hypertension. The problem of studying the association between AH and COVID-19 is also very relevant from an etiopathogenetic point of view, since, both in the development of COVID-19 and in the pathogenesis of AH, one of the key places is occupied by the components of the renin-angiotensin-aldosterone system (RAAS) and, first of all, turn, angiotensin-converting enzyme-2 (ACE-2) and angiotensin II (AII). It has been established that the penetration of the SARS-CoV-2 virus into the body occurs by binding to the RAAS enzyme - ACE-2. This leads to a decrease in the level of ACE-2 and to an increase in the level of AII, which initiates a cytokine storm, damage to the lungs and contributes to the development of severe CVD. On the other hand, AII is one of the most powerful vasoconstrictor factors and plays an extremely important role in the mechanisms of development and progression of hypertension. However, despite the already long period of the COVID-19 pandemic, the features of the course of hypertension in patients who have had this disease have not been adequately studied. The problem of clinical and pathogenetic relationships between AH and COVID-19 remains relevant in 2022, after the start of a new wave of COVID-19 with the dominant Omicron strain.
Aim: study of the features of the course of hypertension in patients after COVID-19.
Materials and methods. 82 patients with AH were examined before and 6-12 weeks after COVID-19 disease. Among the examined patients, 68 patients (83%) had moderate COVID-19, 14 patients (17%) had severe COVID-19. All patients before and after infection with COVID-19 underwent a general clinical laboratory and instrumental examination.
Results. A significant negative impact of COVID-19 on the nature of the course of hypertension was revealed: an increase in the severity of hypertension, the frequency of cardiac arrhythmias, the frequency and severity of heart failure, a decrease in kidney function, destabilization of existing type 2 diabetes and development of new cases of diseases, progression of lipid metabolism disorders and coronary heart disease. A significant contribution to the worsening of the course of AH after CVD is made by the formation of «ongoing symptomatic COVID-19» and astheno-depressive syndrome. Taking into account current data, COVID-19 can directly lead to a worsening of hypertension due to a decrease in ACE-2 levels and an increase in the production of AII, which plays a key role in the pathogenesis of hypertension.
Conclusions. Postponed COVID-19 significantly worsens the course of hypertension, which increases the overall risk of complications and indicates the need for timely initiation of adequate comprehensive treatment.
Key words: coronavirus disease -19- COVID-19, arterial hypertension, renin- angiotensin- aldosterone system, angiotensin converting enzyme-2, angiotensin ІІ.