Coronavirus disease 2019 and hypertension in 2 children
ZHANG Hua-Yong, ZHANG Yong
Department of Cardiology, Wuhan Children's Hospital/Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430016, China
Abstract:This article reports the diagnosis and treatment of two children with coronavirus disease 2019 (COVID-19) and hypertension. Case 1 was a boy aged 13 years and 3 months, with the main manifestations of fever and dry cough; chest CT showed ground-glass opacities, and the nucleic acid test of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) yielded a positive result. Case 2 was a boy aged 13 years and 8 months and had no clinical symptoms; chest CT showed no abnormality, while the nucleic acid test of SARS-CoV-2 yielded a positive result. Both cases were shown with family aggregation of SARS-CoV-2 infection. They had obesity and a family history of hypertension. Continuous blood pressure monitoring in the resting state during hospitalization showed that blood pressure was above the 95% reference interval of normal value for children of the same age, and the two boys were given calcium channel blockers or β-receptor blockers and were then recovered. It is concluded that comprehensive management of children with COVID-19 and underlying cardiovascular diseases, including hypertension, should be taken seriously during the epidemic.
Xu X, Chen P, Wang J, et al. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission[J]. Sci China Life Sci, 2020, 63(3):457-460.
Te Riet L, van Esch JH, Roks AJ, et al. Hypertension:renin-angiotensin-aldosterone system alterations[J]. Circ Res, 2015, 116(6):960-975.
[4]
Patel VB, Zhong JC, Grant MB, et al. Role of the ACE2/angiotensin 1-7 axis of the renin-angiotensin system in heart failure[J]. Circ Res, 2016, 118(8):1313-1326.
Dijkman R, Jebbink MF, Deijs M, et al. Replication-dependent downregulation of cellular angiotensin-converting enzyme 2 protein expression by human coronavirus NL63[J]. J Gen Virol, 2012, 93(Pt 9):1924-1929.
[11]
Imai Y, Kuba K, Rao S, et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure[J]. Nature, 2005, 436(7047):112-116.
[12]
Hamming I, Timens W, Bulthuis ML, et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis[J]. J Pathol, 2004, 203(2):631-637.
[13]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395(10223):497-506.
[14]
Ferrario CM, Jessup J, Chappell MC, et al. Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2[J]. Circulation, 2005, 111(20):2605-2610.
[15]
Mortensen EM, Pugh MJ, Copeland LA, et al. Impact of statins and angiotensin-converting enzyme inhibitors on mortality of subjects hospitalised with pneumonia[J]. Eur Respir J, 2008, 31(3):611-617.
[16]
Ohkubo T, Chapman N, Neal B, et al. Effects of an angiotensin-converting enzyme inhibitor-based regimen on pneumonia risk[J]. Am J Respir Crit Care Med, 2004, 169(9):1041-1055.