The effect of arterial hypertension and coronary heart disease on the course and outcome of COVID‑19

Objective. To investigate the influence of arterial hypertension (AH) and ischemic heart disease (IHD) on the course and outcomes of COVID19, considering their various stages, forms, and target organ involvement. Materials and мethods. A total of 808 COVID19 patients hospitalized in the Intensive Care Unit (ICU) from October 1 to December 31, 2020, aged between 17 and 97 years, were examined. The first group consisted of 246 patients without comorbidities. The second group included 430 patients with AH: 305 with stage II and 125 with stage III. The third group comprised 132 patients with IHD and AH: 84 with angina pectoris, 24 with postinfarction cardiosclerosis, and 24 with acute myocardial infarction (AMI). Clinical and laboratory parameters were assessed for all patients, along with electrocardiography, echocardiography, Doppler ultrasound of the lower extremity veins, and computed tomography (CT) of the thoracic organs. In 110 deceased patients, the severity of lung involvement, signs of heart failure, and the immediate cause of death were evaluated. Results. Among COVID19 patients hospitalized in the ICU, the prevalence of AH was 70%, including 16.5% with IHD, and 22% had concomitant diabetes mellitus. The mortality rate among COVID19 patients without cardiovascular diseases (CVD) was 4.5%. Among those with Stage II AH, including those with IHD and angina, the mortality rates were 8.2% and 14.3%, respectively. In patients with stage III AH with renal or cardiac involvement, mortality rates were 24% and 62.5%, respectively. Conclusion. Risk stratification for mortality, considering the prognostically unfavorable significance of the stages and forms of AH and IHD, as well as concomitant viral infections with respiratory complications, allows for an objective assessment of disease progression and prognosis.