Hypertension as a risk factor for COVID-19 severity and mortality: an integrative review

ABSTRACT

The new coronavirus illness (COVID-19) produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has swiftly grown into a global epidemic. Hypertension has been identified as the most common cardiovascular comorbidity in COVID-19 patients, and it has been shown to increase the risk of hospitalization and mortality. Initial research suggested that renin-angiotensin-aldosterone system inhibitors might raise the likelihood of viral infection and worsen illness severity, generating concern considering the global prevalence of hypertension. Nonetheless, further research supported the use of antihypertensive medicines, noting that they do not worsen the severity of COVID-19 infection in hypertensive individuals, but may have a favorable impact. To yet, the specific mechanism through which hypertension predisposes to adverse outcomes in COVID-19 individuals is unclear. In this study, we discuss the incidence of SARS-CoV-2 infection and hypertension, as well as probable causes, with an emphasis on the dual roles of angiotensin-converting enzyme 2 in COVID-19 and hypertension. The effects of pro-inflammatory factors released by the immune system and gastrointestinal dysfunction in COVID-19 are also discussed, as well as how to manage hypertension with covid-19.