Late Breaking Abstract - COVID-19 in patients with pulmonary hypertension: a national prospective cohort study

Abstract

Background: SARS-Cov2 infection is associated with pulmonary endothelial dysfunction; there is however limited data available on the effect of COVID-19 in patients with pulmonary hypertension (PH).

Methods: We prospectively collected in the French PH network characteristics, management and outcomes of adult patients with precapillary PH who had COVID-19 between 01/02/2020 and 31/04/2021. Clinical, functional, and hemodynamic characteristics of PH before COVID-19 were collected from the French PH registry.

Results: 211 PH patients (including 123 PAH, 47 CTEPH and 22 group 3 PH) experienced COVID-19 and 40.3% of them were outpatients, 32.2% were hospitalized in conventional ward and 27.5% in ICU. Among hospitalized patients (n=126), 54% received corticosteroids, 37.3% high-flow oxygen and 11.1% invasive ventilation. Acute pulmonary embolism was diagnosed in 5 patients. Right ventricular and renal failure occurred in 30.2% and 19.8% of patients, respectively. Fifty-two patients died from COVID-19. Overall mortality was 24.6% and in-hospital mortality 41.3%. No death occurred in outpatients. Non-survivors were significantly older, more frequently male, with comorbidities (diabetes, chronic respiratory diseases, systemic hypertension, chronic cardiac diseases, chronic renal failure) and had more severe PH at the last evaluation before COVID-19 (in terms of NYHA functional class and 6-MWD) (all P<0.05). There was no difference in PAH therapy between survivors and non-survivors.

Conclusions: COVID-19 in patients with precapillary PH was associated with a high in-hospital mortality. The usual risk factors for severe COVID-19 and the severity of PH were associated with mortality in this population.