Pulmonary hypertension: From an orphan disease to a global epidemic

Butrous, Ghazwan

doi:10.21542/gcsp.2020.5

Cited by 10 publications

(8 citation statements)

References 187 publications

(141 reference statements)

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“…Pulmonary hypertension is increasingly considered to be a global disease 193 – 195 . Similarly, COVID-19 has affected all continents, including remote areas.…”

Section: Chronic Sequelae Of Covid-19mentioning

confidence: 99%

“…The presence of endemic infections and polyparasitism has been identified as an important driver of pulmonary hypertension at the global level 193 , 194 , 223 . Many infectious diseases, in particular schistosomiasis, HIV infection and, potentially, tuberculosis, can induce pulmonary vascular diseases 207 – 210 by altering the Zinnate and adaptive immune response to COVID-19 (ref.…”

Section: Chronic Sequelae Of Covid-19mentioning

confidence: 99%

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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 increasingly considered to be a global disease 193 – 195 . Similarly, COVID-19 has affected all continents, including remote areas.…”

Section: Chronic Sequelae Of Covid-19mentioning

confidence: 99%

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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“…One such chemokine is CXCR4, which was found to be highly upregulated in the lungs of patients with COVID-19 ( Ackermann et al, 2020a ; Khalil et al, 2021 ). In addition, SARS-COV-2 viral proteins may interact with different types of cell surface receptors of pulmonary vasculature to induce upregulation of the p38 MAPK pathway ( Grimes and Grimes, 2020 ), VCAM-1 expression ( Birnhuber et al, 2021 ), nuclear factor–kappa B (NF-κB) translocation via the reduction of the dual-specificity phosphatases ( Goel et al, 2021 ), and up-regulation of the hypoxia-inducible factor–1α (HIF-1) ( Taniguchi-Ponciano et al, 2021 ), which, collectively, are implicated in the pathobiology of pulmonary vascular remodeling and dysfunction ( Butrous, 2020 ).…”

Section: The Role Of Sars-cov-2 In the Pathogenesis Of Pulmonary Vasc...mentioning

confidence: 99%

From acute SARS-CoV-2 infection to pulmonary hypertension

2022

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As the world progressively recovers from the acute stages of the coronavirus disease 2019 (COVID-19) pandemic, we may be facing new challenges regarding the long-term consequences of COVID-19. Accumulating evidence suggests that pulmonary vascular thickening may be specifically associated with COVID-19, implying a potential tropism of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) virus for the pulmonary vasculature. Genetic alterations that may influence the severity of COVID-19 are similar to genetic drivers of pulmonary arterial hypertension. The pathobiology of the COVID-19-induced pulmonary vasculopathy shares many features (such as medial hypertrophy and smooth muscle cell proliferation) with that of pulmonary arterial hypertension. In addition, the presence of microthrombi in the lung vessels of individuals with COVID-19 during the acute phase, may predispose these subjects to the development of chronic thromboembolic pulmonary hypertension. These similarities raise the intriguing question of whether pulmonary hypertension (PH) may be a long-term sequela of SARS-COV-2 infection. Accumulating evidence indeed support the notion that SARS-COV-2 infection is indeed a risk factor for persistent pulmonary vascular defects and subsequent PH development, and this could become a major public health issue in the future given the large number of individuals infected by SARS-COV-2 worldwide. Long-term studies assessing the risk of developing chronic pulmonary vascular lesions following COVID-19 infection is of great interest for both basic and clinical research and may inform on the best long-term management of survivors.

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“…Pulmonary hypertension (PH) is defined as mean pulmonary artery pressure (PAP) at rest of >25 mmHg (1). It is divided into five major categories (2).…”

Section: Introductionmentioning

confidence: 99%

“…It is divided into five major categories (2). Currently, one that is of particular clinical relevance is pulmonary arterial hypertension (PAH) (1). An internationally registered epidemiological data on PAH showed that the prevalence of PAH was 15 cases per million adults (2), making it a rare disease.…”

Section: Introductionmentioning

confidence: 99%

Anxiety and Depression in Patients With Pulmonary Arterial Hypertension in Northwest China: A Cross-Sectional Study

et al. 2022

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ObjectivePulmonary arterial hypertension (PAH) is a rare life-threatening and incurable disease. Although symptoms of depression and anxiety have been widely reported, these traits and associated factors have not been systematically assessed in Northwest China.MethodsA cross-sectional study was conducted between March 2020 and February 2021. 106 PAH patients in Northwest China were evaluated by Self-rating Anxiety Scale (SAS) and the Self Rating Depression Scale (SDS) questionnaire.ResultsOverall, the included patients had particularly high depressive symptoms (70.09%), while anxiety among them was 17.55%. Multivariate linear regression revealed that patients with lower age (p = 0.04), female (p< 0.01), smoking (p< 0.01), WHO functional class III/IV (p< 0.01), higher mean pulmonary hypertension (p< 0.01), lower left ventricular ejection fraction (p< 0.01), and lower 6-min walking distance (p< 0.01) had higher anxiety scores. Patients who lived in rural areas (p = 0.01), smoking (p< 0.01), WHO functional class III/IV (p< 0.01), higher mean pulmonary hypertension (p = 0.04), lower 6-min walking distance (p< 0.01), and college degree or above had higher depression scores (p = 0.02).ConclusionsMental health problems such as depression are common among patients with PAH in Northwest China. Patients' characteristics such as smoking status, WHO functional class, and 6-min walking distance were related to anxiety and depression scores. Thus, early detection of mental health problems such as depression and anxiety should be detected in PAH patients. Meanwhile, interventions against these problems should be used to improve such patients' mental status.

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Pulmonary hypertension: From an orphan disease to a global epidemic

Cited by 10 publications

References 187 publications

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

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

From acute SARS-CoV-2 infection to pulmonary hypertension

Anxiety and Depression in Patients With Pulmonary Arterial Hypertension in Northwest China: A Cross-Sectional Study

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