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Reply to: Microvascular hypertensive disease, long COVID, and end-organ pathology

Hypertension Research volume 46, pages 2249–2250 (2023)Cite this article

The Original Article was published on 13 July 2023

We appreciate the opportunity to address the comments by Dr. Cimolai regarding our review article titled “Long COVID and hypertension-related disorders: a report from the Japanese Society of Hypertension Project Team on COVID-19” [1]. In this article, we summarize the possible influences of long COVID on hypertension-related organs, including the cardiovascular systems, kidney, and endocrine systems, as well as the pathophysiological mechanisms associated with these disorders. In our review, we reported that the presentation of long COVID and the impacts of long COVID on hypertension-related organs are extremely heterogeneous. We also revealed that long COVID has a multifactorial nature with multiple pathophysiological factors at play; thus, we agree with the opinion of Dr. Cimolai that the definition of long COVID raises considerable concern, given the rather nebulous and all-encompassing nature of most definitions. We critically need diagnostic criteria that can differentiate the different endotypes of long COVID to ensure precise approaches and to deepen and broaden research related to this condition. Meanwhile, there is no consensus definition of each endotype of long COVID to date, although numerous number of long COVID related studies and review have been published. Nonetheless, multiple large-scale observational studies including the nationwide cohort study from the UK [2] subsequent to the publication of our review article revealed a higher risk of developing hypertension among COVID -19 patients regardless of severity of COVID -19 as post-acute phase and long COVID [3, 4]. Given that long COVID and hypertension may share multiple pathophysiological features, there is no doubt that further research (epidemiological study, clinical study, and basic research) on long COVID and hypertension-related disorders will provide significant benefit to patients suffering from long COVD and hypertension. In addition, as the field of data science experiences rapid growth [5], the abundant COVID -19 related data aggregated globally may contribute significantly to refine endotype definitions of long COVID and uncover novel pathophysiological elements, risk factors, and interventional approaches for both long COVID and hypertension. Nonetheless, the diversity of long COVID symptom assessment methodologies, data collection protocols, and lack of consensus screening tools for individual endotype evaluation, remain areas ripe for future investigation. In addition, the transition of the COVID-19 pandemic to an endemic will bring challenges in assessing exposure to SARS-CoV-2 virus, an essential element of research, due to the use of a self-diagnostic kits for SARS-CoV-2 infection or the potential absence of professional medical consultation. Relentless effort is needed to work together around the world and consciously acquire, accumulate, and analyze COVID-19 related data to overcome long COVID and hypertension-related diseases.

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References

  1. Matsumoto C, Shibata S, Kishi T, Morimoto S, Mogi M, Yamamoto K, et al. Long COVID and hypertension-related disorders: a report from the Japanese Society of Hypertension Project Team on COVID-19. Hypertens Res. 2023;46:601–19.

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  1. Center for Health Surveillance & Preventive Medicine, Tokyo Medical University Hospital, Tokyo, Japan

    Chisa Matsumoto

  2. Department of Cardiology, Tokyo Medical University, Tokyo, Japan

    Chisa Matsumoto

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on behalf of the Japanese Society of Hypertension project team on COVID-19

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Correspondence to Chisa Matsumoto.

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Matsumoto, C., on behalf of the Japanese Society of Hypertension project team on COVID-19. Reply to: Microvascular hypertensive disease, long COVID, and end-organ pathology. Hypertens Res 46, 2249–2250 (2023). https://doi.org/10.1038/s41440-023-01371-2

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