Hypertension in COVID-19, A Risk Factor for Infection or A Late Consequence?

Barekat, Maryam; Shahrbaf, Mohammad Amin; Rahi, Kosar; Vosough, Massoud

doi:10.22074/cellj.2022.8487

Hypertension in COVID-19, A Risk Factor for Infection or A Late Consequence?

Document Type : Letter to The Editor

Authors

¹ Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran

² Research and Development Department, Royan Stem Cell Technology Co, Tehran, Iran

³ Experimental Cancer Medicine, Institution for Laboratory Medicine, Karolinska Institute, Stockholm, Sweden

10.22074/cellj.2022.8487

Abstract

There are a lot of data about the correlation of SARS-CoV-2 infection and hypertension (HTN), but most of them
are in the increased risk of morbidity and mortality in patients with HTN. SARS-CoV-2 can interfere with host cells
through the renin-angiotensin system (RAS) via the angiotensin-converting enzyme 2 (ACE2) receptor. RAS activation
is associated with pro-inflammatory effects through the ACE/Ang II/ Angiotensin II type 1 receptor (AT1R) pathway
or anti-inflammatory effects through ACE2/Ang1-7/Mas axis. In the current paper, we discuss the pathophysiology of
newly diagnosed HTN and its effect on morbidity in patients with coronavirus disease 2019 (COVID-19).

Keywords

References

1. Available from: https://covid19. who.int/ (13 May 2022).
2. Shahrbaf MA, Hassan M, Vosough M. COVID-19 and Hygiene Hypothesis: increment of the Inflammatory Bowel Diseases in next generation? Expert Rev Gastroenterol Hepatol. 2022; 16(1): 1-3.
3. Savoia C, Volpe M, Kreutz R. Hypertension, a moving target in COVID-19: current views and perspectives. Circ Res. 2021; 128(7): 1062-1079.
4. Chen G, Li X, Gong Z, Xia H, Wang Y, Wang X, et al. Hypertension as a sequela in patients of SARS-CoV-2 infection. PLoS One. 2021; 16(4): e0250815.
5. Weber T, Amar J, de Backer T, Burkard T, van der Giet M, Gosse P, et al. Covid-19 associated reduction in hypertension-related diagnostic and therapeutic procedures in Excellence Centers of the European Society of Hypertension. Blood Press. 2022; 31(1): 71-79.
6. Burnier M, Kjeldsen SE, Narkiewicz K, Egan B, Kreutz R. Hypertension management during the COVID-19 pandemic: what can we learn for the future? Blood Press. 2022; 31(1): 47-49.
7. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021; 397(10270): 220-232.
8. Yang J, Petitjean SJL, Koehler M, Zhang Q, Dumitru AC, Chen W, et al. Molecular interaction and inhibition of SARS-CoV-2 binding to the ACE2 receptor. Nat Commun. 2020; 11(1): 4541.
9. Benigni A, Cassis P, Remuzzi G. Angiotensin II revisited: new roles in inflammation, immunology and aging. EMBO Mol Med. 2010; 2(7): 247-257.
10. Capettini LS, Montecucco F, Mach F, Stergiopulos N, Santos RA, da Silva RF. Role of renin-angiotensin system in inflammation, immunity and aging. Curr Pharm Des. 2012; 18(7): 963-970.
11. Issa H, Eid AH, Berry B, Takhviji V, Khosravi A, Mantash S, et al. Combination of angiotensin (1-7) agonists and convalescent plasma as a new strategy to overcome angiotensin converting enzyme 2 (ACE2) inhibition for the treatment of COVID-19. Front Med (Lausanne). 2021; 8: 620990.
12. Brojakowska A, Narula J, Shimony R, Bander J. Clinical implications of SARS-CoV-2 interaction with renin angiotensin system: JACC review topic of the week. J Am Coll Cardiol. 2020; 75(24): 3085-3095.
13. Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020; 20(6): 363-374.
14. Shahriari-Felordi M, Alikhani HK, Hashemian SM, Hassan M, Vosough M. Mini review ATF4 and GRP78 as novel molecular targets in ER-Stress modulation for critical COVID-19 patients. Mol Biol Rep. 2022: 1-5.
15. Bhaskar S, Sinha A, Banach M, Mittoo S, Weissert R, Kass JS, et al. Cytokine storm in COVID-19-immunopathological mechanisms, clinical considerations, and therapeutic approaches: the REPROGRAM consortium position paper. Front Immunol. 2020; 11: 1648.
16. Tomiyama H, Shiina K, Matsumoto-Nakano C, Ninomiya T, Komatsu S, Kimura K, et al. The contribution of inflammation to the development of hypertension mediated by increased arterial stiffness. J Am Heart Assoc. 2017; 6(7): e005729.
17. Castellon X, Bogdanova V. Chronic inflammatory diseases and endothelial dysfunction. Aging Dis. 2016; 7(1): 81-89.
18. Faulkner JL, Belin de Chantemèle EJ. Mineralocorticoid receptor and endothelial dysfunction in hypertension. Curr Hypertens Rep. 2019; 21(10): 78.
19. Ruhl L, Pink I, Kühne JF, Beushausen K, Keil J, Christoph S, et al. Endothelial dysfunction contributes to severe COVID-19 in combination with dysregulated lymphocyte responses and cytokine networks. Signal Transduct Target Ther. 2021; 6(1): 418.
20. Akpek M. Does COVID-19 cause hypertension? Angiology. 2022; 73(7): 682-687.
21. Bekbossynova M, Ainur T. Hypertension as a manifestation of COVID-19 pneumonia. Clin Case Rep. 2021; 9(9): e04720.
22. Tadic M, Saeed S, Grassi G, Taddei S, Mancia G, Cuspidi C. Hypertension and COVID-19: ongoing controversies. Front
Cardiovasc Med. 2021; 8: 639222.