Impact and predictors of outcome of COVID-19 in pulmonary hypertension patients

Abstract

Background The pandemic had a significant impact on those with underlying chronic health conditions being at risk of developing a more severe disease with rapid progression, significant complications, and with increased risk of mortality. This was also expected in the pulmonary vascular community owing to the vulnerable nature of this population, who are characterized by an increase in the pulmonary vascular resistance leading to right heart failure. This study is aiming to identify the incidence of COVID-19 infection among pulmonary hypertension patients receiving specific therapy as well as the predictors of the COVID-19 disease severity and outcome in those patients. Results Data analysis of 197 PAH and CTEPH patients, showed that the incidence of SARS-CoV-2 infection is 10.66% (n = 21). Seven patients (33.3%) required hospitalization. Mortality rate is 14.3% (3/21). Severity of COVID19 disease in those patients has statistically significant moderate to strong correlation with higher values of d-dimer (r = 0.821, P = 0.000), ferritin (r = 0.718, p = 0.000), CRP (r = 0.613, p = 0.04), acute renal failure (r = 0.557, p = 0.009), and hypoxemia (r = 0.825, p = 0.000). Mortality from COVID-19 show moderate to strong statistically significant correlations with acute renal failure (r = 0.795, p = 0.000), hypoxemia (r = 0.645, p = 0.002), higher values of ferritin (r = 0.689, p = 0.001) and d-dimer (r = 0.603, P = 0.004). Conclusions COVID-19 in PAH and CTEPH patients is challenging, higher COVID-19 infection rate is present in those patients and is associated with increased disease severity and higher mortality.