Pulmonary hypertension due to pulmonary embolism secondary to COVID-19: A district general hospital experience from the UK

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Authors
Mahdi, N
Nadeem, I
Ur Rasool, M
Ui Munamm, S A
Khatana, U.F
Rahad, F
Babu, A
Issue Date
2023
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Scientific Paper
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Research Subject Categories::MEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Internal medicine::Lung diseases , Research Subject Categories::MEDICINE::Microbiology, immunology, infectious diseases::Infectious diseases
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Abstract Background: Preliminary data suggest that the prevalence of pulmonary hypertension (PH) in patients with COVID-19 is around 13%, but its prognostic role remains unclear. Approximately 3% of patients develop chronic thrombo-embolic pulmonary hypertension (CTEPH) following diagnosis of acute pulmonary embolism (PE). It is recommended that patients are screened for CTEPH if they remain symptomatic 3 months following diagnosis of PE. The primary aim of the study was to assess the chances of persistent PH following PE secondary to COVID-19. Methods: We conducted a retrospective cohort study at a District General Hospital (DGH) in the United Kingdom. All patients diagnosed with COVID-19 and PE between April 2020 and October 2021 were examined. Patients were divided into two groups:·COVID-19 and PE with comorbidities (excluding pre-existing PH) and·COVID-19 and PE without comorbidities. We compared the ECHO features suggestive of PH between the two groups at the time of diagnosis of PE and at 3 months following treatment. Results: 80 patients were included in the study (49 with comorbidities and 31 with no comorbidities). Average age of comorbidities and no comorbidities groups were 73 years and 70 years, respectively. Average PaO2/FiO2 ratio for comorbidities and no comorbidities groups were 170 and 195, respectively. Fourteen patients (13 with comorbidities and 1 with no comorbidities) died in total. Results showed that risk of persistent PH and subsequent mortality following PE in COVID-19 is 4.17 times and 1.32 times more in comorbidity group as compared to no comorbidity group, respectively (p < 0.001). Conclusion: Patients with comorbidities are at high risk of persistent PH and mortality due to PE secondary to COVID-19. Keywords: COVID-19, pulmonary hypertension, pulmonary embolism, chronic thromboembolic pulmonary hypertension
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Mahdi N, Nadeem I, Ur Rasool M, Ul Munamm SA, Khatana UF, Rashad F, Babu A. Pulmonary hypertension, pulmonary embolism and COVID-19: A district general hospital experience from the UK. J R Coll Physicians Edinb. 2023 Mar;53(1):9-12. doi: 10.1177/14782715231152677. Epub 2023 Jan 27. PMID: 36705094; PMCID: PMC9884629.
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