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I have read with interest a report by Zuin et al., who conducted a meta-analysis to evaluate the risk of new-onset arterial hypertension (HT) in COVID-19 survivors over a mean follow-up of 6.8 months [1]. The pooled hazard ratio (HR) (95% confidence interval [CI]) of COVID-19 patients for new-onset HT was 1.70 (1.46–1.97). The HT risk was directly associated with age, female sex and cancer, and the follow-up length was a moderator on the association. I present comments regarding the study.
The authors pooled data from five retrospective cohort studies. Although causal association between COVID-19 infection and subsequent risk of HT cannot be determined by prospective studies, caution should be paid to the bias for compiling the data. There is a report on the mechanism of the association with special reference to the change of renin-angiotensin-aldosterone-system by COVID-19 infection [2], but many other factors may also contribute to incident HT. We have to understand the magnitude of contribution to incident HT after COVID-19 infection.
The authors observed no significant effect of diabetes mellitus on the new-onset risk of HT, but they did not evaluate the new-onset risk of diabetes mellitus in COVID-19 survivors. There is a need of evaluating changes in glucose levels, blood pressure readings and lipid profiles after recovery from COVID-19, which would lead to the risk assessment of new-onset diabetes mellitus, HT and dyslipidemia as a sequela of a COVID-19 infection [3]. Metabolic components interact with each other, and they are closely related to obesity. I think that further studies are needed to specify the inter-relationship of metabolic components in COVID-19 survivors.
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References
Zuin M, Rigatelli G, Bilato C, Pasquetto G, Mazza A. Risk of incident new-onset arterial hypertension after COVID-19 recovery: a systematic review and meta-analysis. High Blood Press Cardiovasc Prev. 2023;30(3):227–33. https://doi.org/10.1007/s40292-023-00574-5.
Oliveira KB, de Melo IS, da Silva BRM, Oliveira KLDS, Sabino-Silva R, Anhezini L, Katayama PL, Santos VR, Shetty AK, de Castro OW. SARS-CoV-2 and hypertension: evidence supporting invasion into the brain via baroreflex circuitry and the role of imbalanced renin–angiotensin–aldosterone-system. Neurosci Insights. 2023;18:26331055231151926. https://doi.org/10.1177/26331055231151926.
Wrona M, Skrypnik D. New-onset diabetes mellitus, hypertension, dyslipidaemia as sequelae of covid-19 infection-systematic review. Int J Environ Res Public Health. 2022;19(20):13280. https://doi.org/10.3390/ijerph192013280.
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Kawada, T. Risk of Arterial Hypertension After COVID-19 Recovery. High Blood Press Cardiovasc Prev 30, 485 (2023). https://doi.org/10.1007/s40292-023-00597-y
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DOI: https://doi.org/10.1007/s40292-023-00597-y