Medicine Update 2021 -Two Volumes Set PDF Free Download
The COVID-19 pandemic has taken us unprecedented, and management of comorbidities has become challenging as a consequence. Presence of comorbidities has shown to be an increased risk factor for critical illness. Since it’s a relatively new disease, there is a lack of robust clinical data concerning COVID-19 infection and presence of comorbidities. Among the COVID-19 patients who died in Italy, it was observed that those with comorbidities including hypertension (69%), diabetes (31%), ischemic heart disease (27%), atrial fibrillation (21%), and heart failure (16%) were the most important factors for the increased mortality rates observed (Gruppo Della database, 2020). The highest percentage of association was with hypertension. In a meta-analysis done, it was shown that the extent of hyperglycemia was lower in survivors and non-severe subset of patients. Similarly, presence of hypertension was associated with higher mortality rates and necessity of ICU care.1 So far there is no evidence to show that hypertension reduces immunity or increases the predisposition toward getting infected with COVID-19.2
Management of Hypertension in the COVID-19 Era and the Possible Role of RAAS Inhibitors
With the current scenario, it becomes very crucial to manage cardiovascular risk factors to reduce significant morbidity and mortality. A significant proportion of these patients are on renin-angiotensin-aldosterone system (RAAS) inhibitors as therapy for their hypertension. The European Society of Cardiology (ESC) has come up with a recent guidance document under the expert panel of health-care professionals managing COVID-19 concomitantly with cardiovascular disease. Multivariable adjusted models have shown cardiac injury, especially elevated cardiac troponin-T levels to be a significant mortality indicator. Studies have reported that in a significant proportion of COVID-19 patients, direct myocardial injury resulting in elevated cardiac troponins is the main effect seen (approximately 8–12% patients). Presence of pre-existing cardiac disease tends to worsen this.3,4 Additionally, COVID-19 associated pneumonia…
Language : English
Hardcover : 1680 pages
ISBN-10 : 8194874289
ISBN-13 : 978-8194874287
