Open AccessCOVID-19 in Patients with Pulmonary Hypertension: A National Prospective Cohort Study
Author(s) -
David Montani,
Marie-Caroline Certain,
Jason Weatherald,
Xavier Jaïs,
Sophie Bulifon,
É. Noël-Savina,
Aieves,
Sébastien Renard,
Julie Traclet,
Hélène Bouvaist,
Marianne Riou,
P. De Groote,
Pamela Moceri,
Laurent Bertoletti,
Nicolas Favrolt,
Anne Guillaumot,
Étienne-Marie Jutant,
Antoine Beurnier,
Athénaïs Boucly,
Nathan Ebstein,
Mitja Jevnikar,
Jérémie Pichon,
Sophia Keddache,
Mariana Preda,
Anne Roche,
Sabina Solinas,
Andrei Seferian,
Martine ReynaudGaubert,
Vincent Cottin,
Laurent Savale,
Marc Humbert,
Olivier Sitbon,
Ahmad Kazemi,
Élise Artaud-Macari,
Céline Chabanne,
Chaouat Ari,
Dauphin surnameClaire,
Gagnadoux Frédéric,
Gaudoin Anne,
Hascoet Sébastien,
Delphine Horeau-Langlard,
J. Inamo,
Bouchra Lamia,
Pascal Magro,
Meurice Jean-Claude,
P. Poubeau,
Grégoire Prévôt,
Rosario Roger,
Servettaz
Publication year - 2022
Publication title -
american journal of respiratory and critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.272
H-Index - 374
eISSN - 1535-4970
pISSN - 1073-449X
DOI - 10.1164/rccm.202112-2761oc
Subject(s) - medicine , pulmonary hypertension , prospective cohort study , diabetes mellitus , kidney disease , cohort study , endothelial dysfunction , cardiology , endocrinology
Rationale: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with pulmonary endothelial dysfunction. There are limited data available on the outcomes of coronavirus disease (COVID-19) in patients with pulmonary hypertension (PH), a disease characterized by pulmonary endothelial dysfunction. Objectives: To describe characteristics and outcomes of patients with precapillary PH and COVID-19. Methods: We prospectively collected characteristics, management, and outcomes of adult patients with precapillary PH in the French PH network who had COVID-19 between February 1, 2020, and April 30, 2021. Clinical, functional, and hemodynamic characteristics of PH before COVID-19 were collected from the French PH registry. Measurements and Main Results: A total of 211 patients with PH (including 123 with pulmonary arterial hypertension, 47 with chronic thromboembolic PH, and 41 with other types of PH) experienced COVID-19, and 40.3% of them were outpatients, 32.2% were hospitalized in a conventional ward, and 27.5% were in an ICU. Among hospitalized patients ( n = 126), 54.0% received corticosteroids, 37.3% high-flow oxygen, and 11.1% invasive ventilation. Right ventricular and acute renal failure occurred in 30.2% and 19.8% of patients, respectively. Fifty-two patients (all hospitalized) died from COVID-19. Overall mortality was 24.6% (95% CI [confidence interval], 18.8-30.5) and in-hospital mortality 41.3% (95% CI, 32.7-49.9). Nonsurvivors were significantly older, more frequently male and suffering comorbidities (diabetes, chronic respiratory diseases, systemic hypertension, chronic cardiac diseases, and/or chronic renal failure), and had more severe PH at their most recent evaluation preceding COVID-19 diagnosis (in terms of functional class and 6-minute-walk distance; all P < 0.05). Use of pulmonary arterial hypertension therapy was similar between survivors and nonsurvivors. Conclusions: COVID-19 in patients with precapillary PH was associated with a high in-hospital mortality. The typical risk factors for severe COVID-19 and severity of PH were associated with mortality in this population.