Arterial hypertension (AH) is the most common concomitant pathology in patients with COVID-19. AH, regardless of other risk factors, worsens the course of coronavirus infection, which is associated with immune system activation and inflammation in hypertension. Factors, that activate the immune system in AH remain poorly understood. The study aimed to compare the level of IL-6 in patients with AH and concomitant COVID-19 and patients with AH stage ІІ. 82 patients with AH stage ІІ and confirmed SARS-CoV-2 by PCR test. All individuals were divided into 2 groups depending on the severity of coronavirus disease. The first group included 41 patients with moderate COVID-19, the second – 41 patients with severe course of the disease. The control group included 44 individuals with AH stage ІІ. The age of patients with AH in combination with COVID-19 was significantly higher compared to the age of the individuals in the control group. The level of saturation was lower in patients of the group І and ІІ compared to the control group (р<0,01). Creatinine and urea levels were significantly higher in the group ІІ (r=0,77) compared with patients with a moderate course of COVID-19 (р<0,05) normal parameters (р<0,01). The mean level of proinflammatory IL-6 was 1.93 times higher in patients with AH and moderate COVID-19 (р<0,05) and 4.63 times higher in individuals with severe COVID-19 (р<0,01) compared with the control group. These changes may indicate the development of a cytokine storm in these patients.

COVID-19 pneumonia in combination with AH is complicated by the deterioration of renal function, changes in some indicators of hemostasis on the background of decreasing the blood oxygen saturation. The level of saturation was significantly reduced in patients with moderate and severe COVID-19 (р<0,01) and was negatively correlated with the concentration of IL-6 (r=-0,363). As COVID-19 progresses, IL-6 level increases sharply with moderate (р<0,05) and severe (р<0,01) course compared to normal parameters.

Received: 11.02.2022

Keywords: arterial hypertension, COVID-19, IL-6

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1. 1. Gusev D.А., Vashukova М.А., Feduniak I.P., Musatov V.B., Kapatsyna V.A. Experience with the use of recombinant humanized monoclonal antibodies to the human receptor for interleukin-6 in patients with CoVID-19. Journal Infectology. 2020;12(3):28-33.
2. 2. Henderson LA, Canna SW, Schulert GS, Volpi S, Lee PY, Kernan KF, et al. On the Alert for Cytokine Storm: Immunopathology in COVID-19. Arthritis Rheumatol. 2020 Jul;72(7):1059-1063.
3. 3. Moore JB, June CH. Cytokine release syndrome in severe COVID-19. Science. 2020 May 1;368(6490):473-474.
4. 4. Nasonov E.L. Immunopathology and immunopharmacotherapy of coronavirus disease 2019 (COVID-19): focus on interleukin 6. Rheumatology Science and Practice. 2020;58(3):245-261.
5. 5. Li G, Fan Y, Lai Y, Han T, Li Z, Zhou P, et al. Coronavirus infections and immune responses. J Med Virol. 2020 Apr;92(4):424-432.
6. 6. McGonagle D, Sharif K, O'Regan A, Bridgewood C. The Role of Cytokines including Interleukin-6 in COVID-19 induced Pneumonia and Macrophage Activation Syndrome-Like Disease. Autoimmun Rev. 2020 Jun;19(6):102537.
7. 7. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020 May;46(5):846-848.
8. 8. Wang W, Liu X, Wu S, Chen S, Li Y, Nong L, et al. Definition and Risks of Cytokine Release Syndrome in 11 Critically Ill COVID-19 Patients With Pneumonia: Analysis of Disease Characteristics. J Infect Dis. 2020 Oct 1;222(9):1444-1451.
9. 9. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506.
10. 10. Liu T, Zhang J, Yang Y, Ma H, Li Z, Zhang J, et al. The role of interleukin-6 in monitoring severe case of coronavirus disease 2019. EMBO Mol Med. 2020 Jul 7;12(7):e12421.
11. 11. Herold T, Jurinovic V, Arnreich C, Lipworth BJ, Hellmuth JC, von Bergwelt-Baildon M, et al. Elevated levels of IL-6 and CRP predict the need for mechanical ventilation in COVID-19. J Allergy Clin Immunol. 2020 Jul;146(1):128-136.e4.
12. 12. Zhu Z, Cai T, Fan L, Lou K, Hua X, Huang Z, et al. Clinical value of immune-inflammatory parameters to assess the severity of coronavirus disease 2019. Int J Infect Dis. 2020 Jun;95:332-339.
13. 13. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020 Apr 28;323(16):1574-1581.
14. 14. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062.
15. 15. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720.
16. 16. Casucci G, Acanfora D, Incalzi RA. The Cross-Talk between Age, Hypertension and Inflammation in COVID-19 Patients: Therapeutic Targets. Drugs Aging. 2020 Nov;37(11):779-785.
17. 17. Iaccarino G, Grassi G, Borghi C, Ferri C, Salvetti M, Volpe M; SARS-RAS Investigators. Age and Multimorbidity Predict Death Among COVID-19 Patients: Results of the SARS-RAS Study of the Italian Society of Hypertension. Hypertension. 2020 Aug;76(2):366-372.
18. 18. Santa Cruz A, Mendes-Frias A, Oliveira AI, Dias L, Matos AR, Carvalho A, Capela C, Pedrosa J, Castro AG, Silvestre R. Interleukin-6 Is a Biomarker for the Development of Fatal Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia. Front Immunol. 2021 Feb 18;12:613422.
19. 19. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020 Apr;18(4):844-847.
20. 20. Fukao, Y., Nagasawa, H., Nihei, Y. et al. COVID-19-induced acute renal tubular injury associated with elevation of serum inflammatory cytokine. Clin Exp Nephrol 25, 1240–1246 (2021).
21. 21. Xiang, HX., Fei, J., Xiang, Y. et al. Renal dysfunction and prognosis of COVID-19 patients: a hospital-based retrospective cohort study. BMC Infect Dis 21, 158 (2021).