Hypertension and diabetes mellitus in patients with COVID 19: a viewpoint on mortality.

Abstract

The outbreak of coronavirus disease 2019 (COVID 19) by the novel corona virus SARS-CoV2 is the leading worldwide healthcare problem due to its contagious nature, high morbidity and mortality rates. The present pandemic has also brought an emerging situation regarding the cardiovascular complications and comorbid disease mainly pointing out hypertension (HT) and diabetes mellitus (DM). Early clinical observations have shown that HT and DM are the main comorbid disease along with cardiovascular disease, chronic obstructive lung disease and malignancies [1]. The incidences of hypertension, cardiacerebrovascular diseases and diabetes have been found to be about twofold, three and twofold, respectively, higher in ICU/severe cases than in their non-ICU/ severe counterparts by the meta-analysis of Li et al. [2]. Similarly the age and certain co-morbidities (hypertension, diabetes, etc.) have been reported to be important risk factors for mortality among the 25 death cases of with COVID-19 [1]. This worrisome situation has been further aggravated by the potential upregulation of angiotensin converting enzyme 2 in hypertensive and diabetic patients and, more interestingly, in those receiving angiotensin converting enzyme inhibitors and angiotensin receptor antagonists, thereby facilitating the inoculation of lung tissue by COVID 19 [3]. Within this context, these findings might be regarded as an alerting scenario with gloomy consequences for those with HT and DM. This concern has been surpassed by the recommendation of cardiovascular societies against to the discontinuation of angiotensin converting enzyme inhibitors and rennin–angiotensin aldosteron antagonist due to the outbreak of COVID 19 [4].