COVID-19 in Pulmonary Artery Hypertension (PAH) Patients: Observations from a Large PAH Center in New York City

Sulica, Roxana; Cefali, Frank; Motschwiller, Caroline; Fenton, Rebecca; Barroso, Anabela; Sterman, Daniel H.

doi:10.3390/diagnostics11010128

Cited by 26 publications

(26 citation statements)

References 18 publications

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“…If this were the case, VD of the retina measured by OCT-A would be of use as a marker of widespread organ injury in post-COVID-19 patients. Hekimsoy et al 33 have already established a negative correlation between retinal perfusion and idiopathic pulmonary arterial hypertension, a pathology that has been studied in recent times in the context of COVID-19 34 and that results in a higher fatality rate when SARS-CoV-2 infection occurs. Further studies to correlate systemic signs/symptoms are necessary to elucidate this question.…”

Section: Discussionmentioning

confidence: 99%

Persistent reduction of retinal microvascular vessel density in patients with moderate and severe COVID-19 disease

et al. 2022

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ObjectiveThis study aims to analyse the possible recovery or worsening in retinal microvasculature after 8 months in a previously studied COVID-19 cohort.Methods and analysisA cross-sectional case–control study and a prospective longitudinal cohort study. Participants were the subjects of our previous study who re-enrolled for a new examination including a fundus photograph (retinography), an optical coherence tomography (OCT) scan and an OCT angiography. COVID-19 diagnosed patients were divided into three groups: group 1: mild disease, asymptomatic/paucisymptomatic subjects who received outpatient care; group 2: moderate disease and group 3: severe disease, both of which required hospital admission because of pneumonia. Statistical analyses were performed using SPSS software (V.23.0). Cross-sectional intergroup differences were analysed by means of analysis of variance for normally distributed variables and the Kruskal-Wallis test for non-normally distributed ones. In reference to the prospective part of the study (intragroup differences, baseline with 8-month comparison), a paired t-test was used for normally distributed data and Wilcoxon signed ranks sum for non-normally distributed data.ResultsThe fovea-centered superficial and deep vascular densities were significantly diminished in severe cases compared with mild cases (p=0.004; p=0.003, respectively, for superficial and deep) and to controls (p=0.014; p=0.010), also in moderate cases to mild group (p=0.004; p=0.003) and to controls (p=0.012; p=0.024). In the longitudinal study, no significant statistical differences were found between baseline and 8-month follow-up vessel density values.ConclusionWe demonstrated persistent reduction in the central vascular area over time in patients with moderate and severe COVID-19.

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Section: Discussionmentioning

confidence: 99%

Persistent reduction of retinal microvascular vessel density in patients with moderate and severe COVID-19 disease

et al. 2022

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“…An observational study from a large pulmonary hypertension centre in New York City, USA, showed that pre-existing chronic pulmonary hypertension has major adverse effects on both the clinical course and mortality associated with COVID-19 (ref. 198 ). By contrast, another study on data from 32 pulmonary hypertension centres in the USA reported a paucity of hospitalized patients with both pulmonary hypertension and COVID-19, and those who developed COVID-19 had mild symptoms and tended to recover quickly 199 .…”

Section: Chronic Sequelae Of Covid-19mentioning

confidence: 99%

Potential long-term effects of SARS-CoV-2 infection on the pulmonary vasculature: a global perspective

et al. 2021

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The lungs are the primary target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with severe hypoxia being the cause of death in the most critical cases. Coronavirus disease 2019 (COVID-19) is extremely heterogeneous in terms of severity, clinical phenotype and, importantly, global distribution. Although the majority of affected patients recover from the acute infection, many continue to suffer from late sequelae affecting various organs, including the lungs. The role of the pulmonary vascular system during the acute and chronic stages of COVID-19 has not been adequately studied. A thorough understanding of the origins and dynamic behaviour of the SARS-CoV-2 virus and the potential causes of heterogeneity in COVID-19 is essential for anticipating and treating the disease, in both the acute and the chronic stages, including the development of chronic pulmonary hypertension. Both COVID-19 and chronic pulmonary hypertension have assumed global dimensions, with potential complex interactions. In this Review, we present an update on the origins and behaviour of the SARS-CoV-2 virus and discuss the potential causes of the heterogeneity of COVID-19. In addition, we summarize the pathobiology of COVID-19, with an emphasis on the role of the pulmonary vasculature, both in the acute stage and in terms of the potential for developing chronic pulmonary hypertension. We hope that the information presented in this Review will help in the development of strategies for the prevention and treatment of the continuing COVID-19 pandemic.

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“…Pulmonary hypertension is a heterogeneous illness, and only pts with PAH and chronic thromboembolic pulmonary hypertension (CTEPH), i.e., groups 1 and 4 according to WHO classification, are qualified for disease-specific treatment [ 9 ]. It is known that pts with PAH have a high risk of mortality during hospitalizations due to non-cardiovascular diseases [ 10 , 11 , 12 ]. Therefore, the combination of coronavirus infection and pre-existing pulmonary hypertension is a clinically difficult situation associated with a high risk of death, both due to the potentially severe course of COVID-19 and threatened right ventricular failure as a result of the worsening of pulmonary hypertension, e.g., due to hypoxia.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Pulmonary Hypertension Patients: Insights from the BNP-PL National Database

Mamzer

Waligóra

Kopeć

et al. 2022

IJERPH

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We aimed to evaluate the clinical course and impact of the SARS-CoV-2 pandemic on the rate of diagnosis and therapy in the complete Polish population of patients (pts) with pulmonary arterial hypertension (PAH-1134) and CTEPH (570 pts) treated within the National Health Fund program and reported in the national BNP-PL database. Updated records of 1704 BNP-PL pts collected between March and December 2020 were analyzed with regard to incidence, clinical course and mortality associated with COVID-19. Clinical characteristics of the infected pts and COVID-19 decedents were analyzed. The rates of new diagnoses and treatment intensification in this period were studied and collated to the proper intervals of the previous year. The incidence of COVID-19 was 3.8% (n = 65) (PAH, 4.1%; CTEPH, 3.2%). COVID-19-related mortality was 28% (18/65 pts). Those who died were substantially older and had a more advanced functional WHO class and more cardiovascular comorbidities (comorbidity score, 4.0 ± 2.1 vs. 2.7 ± 1.8; p = 0.01). During the pandemic, annualized new diagnoses of PH diminished by 25–30% as compared to 2019. A relevant increase in total mortality was also observed among the PH pts (9.7% vs. 5.9% pre-pandemic, p = 0.006), whereas escalation of specific PAH/CTEPH therapies occurred less frequently (14.7% vs. 21.6% pre-pandemic). The COVID-19 pandemic has affected the diagnosis and treatment of PH by decreasing the number of new diagnoses, escalating therapy and enhancing overall mortality. Pulmonary hypertension is a risk factor for worsened course of COVID-19 and elevated mortality.

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COVID-19 in Pulmonary Artery Hypertension (PAH) Patients: Observations from a Large PAH Center in New York City

Cited by 26 publications

References 18 publications

Persistent reduction of retinal microvascular vessel density in patients with moderate and severe COVID-19 disease

Persistent reduction of retinal microvascular vessel density in patients with moderate and severe COVID-19 disease

Potential long-term effects of SARS-CoV-2 infection on the pulmonary vasculature: a global perspective

Impact of the COVID-19 Pandemic on Pulmonary Hypertension Patients: Insights from the BNP-PL National Database

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