ABSTRACT
Introduction: The world is currently facing the fourth wave of the COVID-19 pandemic. The aim of this study is to assess the effect of this pandemic on ambulatory blood pressure measurements (ABPM) and to investigate the effect of SARS-CoV2 infection on blood pressure (BP). Methods: We conducted a uni-centric retrospective study on the ERASME hospital ABPM register, from 2010 to 2021. The nycthemeral blood pressure (BP) profile of the pandemic period (January 2020 to October 2021) was compared with that of the previous 5 control periods from January 2010 to October 2019. We also determined the diurnal, nocturnal and 24-hour high blood pressure frequencies for each period. Furthermore, for the COVID-19 period, the BP profiles of COVID-19 positive and negative patients were compared. Finally, in COVID-19 positive patients, we compared ABPMs performed before COVID-19 infection with those performed post-infection. Results: After excluding incomplete and poor-quality ABPM, 16,977 ABPMs were selected. The COVID-19 period accounted for 10.58% of ABPMs compared with 15-20% for pré-COVID periods. We observed that diurnal (83.20 vs 81.20;p < 0.001), nocturnal (73.02 vs 71.09;p < 0.001) and 24-hour (79.51 vs 77.50;p < 0.001) diastolic BPs were higher in the COVID-19 period. In contrast, diurnal (131.64 vs 133.18;p < 0.001), nocturnal (121.07 vs 121.93;p = 0.034) and 24- hour (127.82 vs 128.97;p < 0.001) systolic BPs were lower during the pandemic. In logistic regression, diastolic diurnal (OR:1.58 [1.33-1.89];p < 0.001), nocturnal (OR:1.18 [1.02 - 1.36];p = 0.026) and 24-hour (OR:1.22 [1.01 - 1.49];p = 0.044) hypertension were associated with the COVID-19 period, when adjusted for age, gender or history of hypertension. Also, diurnal (OR:0.63 [0.55-0.71];p < 0.001) and nocturnal (OR:0.82 [0.72-0.93];p = 0.002) systolic hypertension were less frequent in the COVID-19 period. When comparing BPs between COVID- 19 positive and negative patients, there was no significant difference. When ABPMs were compared before and after infection in COVID-19 positive patients, diastolic diurnal (88.41 vs. 78.88;p = 0.001), nocturnal (77.91 vs. 70.55;p = 0.027) and 24-hour (84.57 vs. 75.99;p = 0.002) BPs were higher after COVID-19 infection. Conclusion: Our study shows that during the COVID-19 pandemic, diastolic BP was higher and systolic BP was lower compared to the pre-COVID-19 period. We also observed an increase in diastolic BP after COVID-19 infection.
ABSTRACT
Objective: The world is currently facing the fourth wave of the COVID-19 pandemic. The purpose of this study was to assess the effect of this pandemic on ambulatory blood pressure measurements and to compare the blood pressure profile between COVID-19 positive and negative patients. Design and method: We performed a unicentric, retrospective study on the register of ambulatory blood pressure measurements (ABPM) of the ERASME Hospital from 2010 to 2021. ABPMs performed during the pandemic period (January 2020 to October 2021) were compared with those from 5 previous control periods. In order to improve the comparison of the different periods, we considered variations (delta) of each period from the previous 3 months. For all patients whose ABPM was performed during the COVID-19 period, we looked for COVID test results preceding the ABPM. These patients were classified into 2 groups COVID positive, if at least one PCR or serological test was positive, and COVID negative if not. Data analysis was performed using SPSS version 23.0. Results: After exclusion of incomplete and poor-quality ABPMs, 18766 were retained, of which 1796 (9.57%) were for the COVID-19 period. The control periods represented 14.77% to 18.81% of the MAPAs in the study. We observed that diurnal, nocturnal and 24-hour diastolic blood pressures (BP) were higher in the COVID-19 period than in the previous 5 periods ranging from January 2010 to October 2019. Pulse pressure was lower in the COVID-19 period compared to the previous periods. Of the 1796 patients in the COVID-19 period, pre-ABPM COVID- 19 status were obtained from 368 patients, 322 negatives and 46 positives. In COVID-19 positive patients, daytime systolic BP was higher than in COVID-19 negative patients (88,41 ± 11,74 vs 84,63 ± 12,24;p = 0.047). Also, the pulse pressure of COVID-19 positive patients was lower (44,46 ± 7,72 vs 47,57 ± 8,84). No significant differences were observed between the two groups for the other parameters. Conclusions: The COVID-19 pandemic resulted in increased daytime and nighttime diastolic blood pressures. Also, this study suggests an increase in diurnal diastolic blood pressure after COVID-19 infection.