Association of N-terminal pro C-type natriuretic peptide and endothelin-1 levels with the risk of cardiovascular complications in arterial hypertension six months after COVID-19

Shuvalova A.S., Prokofieva T.V., Polunina O.S., Polunina E.A.

Astrakhan State Medical University, Department of Internal Medicine, Faculty of Pediatrics, Astrakhan, Russia

Background. Despite the significant decline in the prevalence of COVID-19 around the world, the consequences of the pandemic on the health and quality of life of patients according to the data from clinical studies will remain a leading public health issue for a long time. Objective. Dynamic evaluation and analysis of the N-terminal pro C-type natriuretic peptide (NUPC) and endothelin-1 (ET-1) levels in patients six months after COVID-19 against the background of arterial hypertension (AH), depending on the stratification of cardiovascular risk in AH. Methods. 45 hypertensive patients with confirmed diagnosis of coronavirus infection COVID-19 (virus identified) who were treated in an infectious diseases hospital were examined. Determination of the NUPC and ET-1 levels in blood serum samples was carried out using the enzyme immunoassay method. Biomarker levels were determined twice – on the first day of admission to the hospital and six months after discharge. Cardiovascular risk in AH was also assessed twice – on the first day of admission to the hospital and six months after discharge. Results. Analysis of the NUPC and ET-1 levels on hospital admission between patients with moderate risk (risk 2) and high risk (risk 3) did not show statistically significant differences (P=0.487, P=0.821, respectively). Six months after COVID-19, in hypertensive patients with very high risk (risk 4), the levels of both ET-1 and NUPC were statistically significantly higher than in patients with high risk (risk 3) (P=0.012 and P<0.001, respectively). An increase in cardiovascular risk in AH six months after discharge from hospital was observed in 15 (33.3%) patients, and in 30 (66.7%) patients, cardiovascular risk in AH remained the same. In hypertensive patients who experienced an increase in cardiovascular risk six months after discharge from hospital for COVID-19, the levels of both ET-1 and NUPC were statistically significantly higher compared with patients who cardiovascular risk in AH did not change (P=0.01 and P<0.001, respectively). Conclusion. According to the results of the study, it was found that the highest levels of both ET-1 and NUPC six months after discharge from the hospital were in patients with a very high risk (risk 4) and in patients who had an increase in cardiovascular risk in AH.

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About the Authors

Corresponding author: Ekaterina A. Polunina, Dr. Sci. (Med.), Professor of the Department of Internal Medicine Faculty of Pediatrics, Astrakhan State Medical University, Astrakhan, Russia; gilti2@yandex.ru

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