Investigating the Relationship Between High Levels of Angiotensin II in Plasma and the Rate of Deterioration in Hypertensive Patients to COVID-19

The COVID-19 crisis poses a heightened risk to vulnerable populations. Considering factors influencing deterioration, complications, and mortality, it is especially important to pay attention to these groups, including persons with hypertension (HTN) and diabetes. This study aimed to investigate the correlation between the angiotensin II (ANG II) level and the disease severity and clinical course in COVID-19 patients.

A cross-sectional study was conducted on 50 COVID-19 patients (mean age 59.1 ± 20) admitted to Sinai hospital in Hamedan. The blood samples of the patients were taken during hospitalization and discharge, and the plasma ANG II level was measured using an enzymelinked immunosorbent assay kit. The quantitative comparison was analyzed with paired t test and qualitative comparison with the chi-square test. The correlation of variables was checked with the Pearson test, and P < 0.05 was considered statistically significant.

Overall, 44%, 16%, and 10% of COVID-19 patients had HTN, cardiovascular disease (CVD), and 10% diabetes, respectively. The oxygen level of 82% of the patients was below 90, of which 68% were intubated, and the lowest oxygen levels were observed in patients with HTN and CVD with 2 deaths. The primary and secondary examination of the ANG II level demonstrated that its level was significantly higher during illness compared to full recovery and decreased during recovery.

The ANG II level is related to the severity of the disease in the early stages of 2019- nCoV infection. Therefore, HTN or other diseases that affect the level of ANG II in the blood can increase the severity of the disease.