Chronic thromboembolic pulmonary hypertension and clot resolution after COVID-19-associated pulmonary embolism

Jong, Cindy M.M. de; Visser, Chantal; Bemelmans, Remy H.H.; Boersma, Wim; Borst, Bram van den; Burggraaf, Jacobus; Cannegieter, Suzanne C.; Cate‐Hoek, Arina J. ten; Faber, Harald J.; Faber, Laura M.; Hellemons, Merel E.; Hessels, Lisa M; Huisman, Menno V.; Kamphuisen, Pieter Willem; Koster, Stephanie C E; Kroft, Lucia J.M.; Lee, Ivo van der; Leentjens, Jenneke; Meijer, Karina; Ninaber, Maarten K; Sondermeijer, Brigitte M.; Stads, Susanne; Vonk‐Noordegraaf, Anton; Winckers, Kristien; Kruip, Marieke J H A; Klok, Frederikus A.

doi:10.1183/13993003.00171-2023

Cited by 7 publications

(5 citation statements)

References 15 publications

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“…This study reported an incidence of 3.89% [23]. By contrast, a recent crosssectional analysis from de Jong et al [24] showed that, after a mean of 19 months, no patients developed CTEPH related with SARS-CoV-2 infection. Our prospective study shows that the incidence of COVID-19-related CTEPH is lower than that observed in several cohorts of patients with non-COVID-19 CTEPH [6][7][8][9]25].…”

Section: Discussioncontrasting

confidence: 62%

Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism in SARS-CoV-2

Caguana-Vélez,

Khilzi,

Piccari

et al. 2024

Respiration

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Introduction: Chronic thromboembolic pulmonary disease (CTEPD) consists of persistent pulmonary vascular obstruction on imaging and involves long-term functional limitations, with or without chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to evaluate the incidence and risk factors of both persistent pulmonary vascular defects and CTEPH after hospitalization in patients with COVID-19 and PE during a 2-year follow-up. Methods: A prospective observational study was carried out in a tertiary hospital center. Patients were hospitalized between March 2020 and December 2021 with a diagnosis of PE during SARS-CoV-2 infection. Patients received anticoagulant treatment for at least 3 months and were followed up for 2 years. Between the third and fourth months after discharge, all patients were evaluated for the presence of residual thrombotic defects by CTPA and/or perfusion pulmonary scintigraphy. Clinical findings, lung function tests with DLCO, exercise capacity, and echocardiograms were also assessed. Results: Of the 133 patients included, 18% had persistent thrombotic defects on lung imaging at follow-up. The incidence of CTEPD was 0.75% at 2 years of follow-up. Patients with persistent defects were significantly older, had a higher prevalence of systemic arterial hypertension, higher D-dimer and NT-proBNP levels, and more severe PE at diagnosis. Furthermore, there was a higher prevalence of right ventricular dysfunction on echocardiogram at diagnosis of PE (25.0% vs. 2.7%, p = 0.006). This was the only variable independently related to persistent defects in multivariate analyses (OR: 8.13 [95% CI: 1.82–36.32], p = 0.006). Conclusion: The persistence of thrombotic defects after PE is a common finding after SARS-CoV-2 infection, affecting 18% of the population. However, the incidence of CTEPH appears to be lower (0.75%) in COVID-19-related PE compared to that previously observed in PE unrelated to COVID-19.

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Section: Discussioncontrasting

confidence: 62%

Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism in SARS-CoV-2

Caguana-Vélez,

Khilzi,

Piccari

et al. 2024

Respiration

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“…This chronic complication negatively affects quality of life 40 , 41 . However, long-term complications after COVID-19 associated PE seem to be similar to non-COVID-19 associated PE 42 .…”

Section: Discussionmentioning

confidence: 80%

Changes in incidence of hospitalization for cardiovascular diseases during the COVID-19 pandemic in The Netherlands in 2020

Kempers

Chen

Visser

et al. 2023

Sci Rep

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This population-based cohort study aimed to describe changes in incidence of cardiovascular disease (CVD) hospital diagnoses during the COVID-19 pandemic in The Netherlands compared with the pre-pandemic period. We used Dutch nationwide statistics about hospitalizations to estimate incidence rate ratios (IRR) of hospital diagnoses of CVD during the first and second COVID-19 waves in The Netherlands in 2020 versus the same periods in 2019. Compared with 2019, the incidence rate of a hospital diagnosis of ischemic stroke (IRR 0.87; 95% CI 0.79–0.95), major bleeding (IRR 0.74; 95% CI 0.68–0.82), atrial fibrillation (IRR 0.73; 95% CI 0.65–0.82), myocardial infarction (IRR 0.78; 95% CI 0.72–0.84), and heart failure (IRR 0.74; 95% CI 0.65–0.85) declined during the first wave, but returned to pre-pandemic levels throughout 2020. However, the incidence rate of a hospital diagnosis of pulmonary embolism (PE) increased during both the first and second wave in 2020 compared with 2019 (IRR 1.30; 95% CI 1.15–1.48 and IRR 1.31; 95% CI 1.19–1.44, respectively). In conclusion, we observed substantial declines in incidences of CVD during the COVID-19 pandemic in The Netherlands in 2020, especially during the first wave, with an exception for an increase in incidence of PE. This study contributes to quantifying the collateral damage of the COVID-19 pandemic.

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“…Pulmonary hypertension, as a serious cardiopulmonary complication of COVID-19,increasing the likelihood of requiring intensive care unit care, mechanical ventilation, extracorporeal membrane oxygenation (ECMO), and even death. Therefore, detecting high pulmonary artery pressure in SARS-CoV-2 patients early might enhance the long-term prognosis of patients and minimize the hospitalization rate and death owing to such complications 7 – 9 , 26 .But de Jong CMM 27 found that chronic thromboembolic pulmonary hypertension is not a more common long-term complication after COVID-19-associated pulmonary embolism than after non-COVID-19-associated pulmonary embolism. Whether this phenomenon is due to large differences in pathogenesis, it is particularly important to study the pathogenesis of COVID-19 combined with pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%

Potential therapeutic targets for COVID-19 complicated with pulmonary hypertension: a bioinformatics and early validation study

Hou,

Jiang,

et al. 2024

Sci Rep

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Coronavirus disease (COVID-19) and pulmonary hypertension (PH) are closely correlated. However, the mechanism is still poorly understood. In this article, we analyzed the molecular action network driving the emergence of this event. Two datasets (GSE113439 and GSE147507) from the GEO database were used for the identification of differentially expressed genes (DEGs).Common DEGs were selected by VennDiagram and their enrichment in biological pathways was analyzed. Candidate gene biomarkers were selected using three different machine-learning algorithms (SVM-RFE, LASSO, RF).The diagnostic efficacy of these foundational genes was validated using independent datasets. Eventually, we validated molecular docking and medication prediction. We found 62 common DEGs, including several ones that could be enriched for Immune Response and Inflammation. Two DEGs (SELE and CCL20) could be identified by machine-learning algorithms. They performed well in diagnostic tests on independent datasets. In particular, we observed an upregulation of functions associated with the adaptive immune response, the leukocyte-lymphocyte-driven immunological response, and the proinflammatory response. Moreover, by ssGSEA, natural killer T cells, activated dendritic cells, activated CD4 T cells, neutrophils, and plasmacytoid dendritic cells were correlated with COVID-19 and PH, with SELE and CCL20 showing the strongest correlation with dendritic cells. Potential therapeutic compounds like FENRETI-NIDE, AFLATOXIN B1 and 1-nitropyrene were predicted. Further molecular docking and molecular dynamics simulations showed that 1-nitropyrene had the most stable binding with SELE and CCL20.The findings indicated that SELE and CCL20 were identified as novel diagnostic biomarkers for COVID-19 complicated with PH, and the target of these two key genes, FENRETI-NIDE and 1-nitropyrene, was predicted to be a potential therapeutic target, thus providing new insights into the prediction and treatment of COVID-19 complicated with PH in clinical practice.

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Chronic thromboembolic pulmonary hypertension and clot resolution after COVID-19-associated pulmonary embolism

Cited by 7 publications

References 15 publications

Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism in SARS-CoV-2

Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism in SARS-CoV-2

Changes in incidence of hospitalization for cardiovascular diseases during the COVID-19 pandemic in The Netherlands in 2020

Potential therapeutic targets for COVID-19 complicated with pulmonary hypertension: a bioinformatics and early validation study

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