COVID-19 and arterial hypertension: points of contact and outcomes of the pathological process

Today, the world is at the mercy of a new virus belonging to the coronavirus family called SARS-CoV-2, and the infection it causes is called COVID-19. The virus can be traced back to December 2019, and is known to have originated in Wuhan district of Hubei province in China. This highly contagious virus has spread to 220 countries and territories around the world, and by mid-March 2020, the World Health Organization recognized it as a pandemic. The infection spreads from person to person through close contact, from mostly symptomatic individuals and asymptomatic carriers. Studies have shown that arterial hypertension (AH), along with diabetes mellitus and cardiovascular disease, were the most common comorbidities among patients with coronavirus infection (COVID-19). Arterial hypertension was consistently listed as the most common risk factor in patients with COVID-19. Several studies have suggested a link between the renin-angiotensin-aldosterone system (RAAS) and susceptibility to COVID-19, as well as a link between RAAS inhibitors and increased mortality in these patients. This has raised concerns about the potential association between AH (and its treatment) and susceptibility to COVID-19. There have been several follow-up studies examining the effect of comorbidities on outcome in these patients with conflicting results. Arterial hypertension has been shown to be more common in patients with an adverse outcome (admission to the ICU, use of a ventilator, or death). So far, there are no studies demonstrating an independent prognostic value of arterial hypertension on mortality in patients with COVID-19. There is much speculation about coronavirus infection and its association with various risk factors and underlying diseases. The purpose of this review is to summarize current knowledge about the relationship between AH and COVID-19 and its role in outcome in these patients.