Abstract
There are several risk factors for worse outcomes in patients with coronavirus 2019 disease (COVID-19). Patients with hypertension appear to have a poor prognosis, but there is no direct evidence that hypertension increases the risk of new infection or adverse outcomes independent of age and other risk factors. There is also concern about use of renin-angiotensin system (RAS) inhibitors due to a key role of angiotensin-converting enzyme 2 receptors in the entry of the SARS-CoV-2 virus into cells. However, there is little evidence that use of RAS inhibitors increases the risk of SARS-CoV-2 virus infection or worsens the course of COVID-19. Therefore, antihypertensive therapy with these agents should be continued. In addition to acute respiratory distress syndrome, patients with severe COVID-19 can develop myocardial injury and cytokine storm, resulting in heart failure, arteriovenous thrombosis, and kidney injury. Troponin, N-terminal pro-B-type natriuretic peptide, D-dimer, and serum creatinine are biomarkers for these complications and can be used to monitor patients with COVID-19 and for risk stratification. Other factors that need to be incorporated into patient management strategies during the pandemic include regular exercise to maintain good health status and monitoring of psychological well-being. For the ongoing management of patients with hypertension, telemedicine-based home blood pressure monitoring strategies can facilitate maintenance of good blood pressure control while social distancing is maintained. Overall, multidisciplinary management of COVID-19 based on a rapidly growing body of evidence will help ensure the best possible outcomes for patients, including those with risk factors such as hypertension.
Keywords: COVID-19; angiotensin receptor blockers; angiotensin-converting enzyme inhibitors; biomarkers; cardiac injury; home blood pressure monitoring; hypertension; telemedicine.
【저자키워드】 COVID-19, Biomarkers, Telemedicine, hypertension, Angiotensin receptor blockers, cardiac injury, angiotensin-converting enzyme inhibitors, home blood pressure monitoring, 【초록키워드】 Respiratory distress syndrome, Cytokine storm, coronavirus, pandemic, Biomarker, Biomarkers, Risk factors, thrombosis, severe COVID-19, acute respiratory distress syndrome, social distancing, Infection, peptide, risk, D-dimer, troponin, SARS-CoV-2 virus, cytokine, Telemedicine, outcome, risk factor, hypertension, angiotensin-converting enzyme 2, RAS, adverse outcomes, Angiotensin receptor blockers, Kidney injury, adverse outcome, renin-angiotensin system, cardiac injury, risk stratification, heart failure, myocardial injury, cells, management, angiotensin-converting enzyme inhibitors, Patient, Complication, age, Health status, receptor, virus infection, Patient management, inhibitor, Other, patients, Angiotensin-converting enzyme, acute respiratory distress, Evidence, creatinine, angiotensin, blood pressure, RAS inhibitors, maintenance, Psychological well-being, independent of, best, respiratory distress, new infection, regular exercise, serum creatinine, Factor, Renin, syndrome, poor prognosis, help, coronavirus 2019 disease, SARS-CoV-2 virus infection, N-terminal pro-B-type natriuretic peptide, MONITOR, N-terminal, angiotensin-converting enzyme 2 receptors, antihypertensive therapy, independent, Course, resulting, develop, include, addition, facilitate, can be used, increase, maintain, patients with COVID-19, pro-B-type natriuretic peptide, RAS inhibitor, the SARS-CoV-2 virus, 【제목키워드】 Asia, network,