ABSTRACT
INTRODUCTION: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) lead to progressive right heart failure. The mortality rates in PAH and CTEPH patients due to COVID19 are high, and vaccination against COVID19 is recommended in this group. OBJECTIVES: We analyzed the incidence and outcomes of COVID19in the PAH/CTEPH patients for 2 years of the pandemic, as well as the predictors of worse outcomes of COVID19 in this group. PATIENTS AND METHODS: PAH/CTEPH patient data for this observational, cohort study were obtained from 3 pulmonary hypertension centers between March 11, 2020 and March 11, 2022. RESULTS: A total of 364 consecutive patients with PAH/CTEPH (248/122; 232 women [64%]; median [interquartile range] age, 61 years [18-92]) were included in the study. All the patients had advanced pulmonary hypertension at baseline. Eightyfive patients (23%) suffered from COVID19. Seven of them (8%), all of whom were unvaccinated, died of COVID19. The unvaccinated patients suffered from COVID19 more often than the vaccinated ones (46% vs 9%; P <0.001). As many as 31% of the PAH/CTEPH patients with COVID19 needed hospitalization, in 8% of cases in the intensive care unit. Age equal to or above 65 years and severe pulmonary hypertension defined as a World Health Organization functional class 3 or 4 were associated with severe COVID19 in the PAH/CTEPH patients. CONCLUSIONS: The vaccinated PAH/CTEPH patients suffered from COVID19 less frequently than the unvaccinated ones. The mortality rate and hospitalization due to COVID19 were higher in the PAH/CTEPH patients than in the general population. All efforts should be made to convince the PAH/CTEPH patients to vaccinate against COVID19.
Subject(s)
COVID-19 , Hypertension, Pulmonary , Pulmonary Arterial Hypertension , Humans , Female , Middle Aged , Aged , Hypertension, Pulmonary/etiology , SARS-CoV-2 , Cohort Studies , COVID-19/complicationsABSTRACT
PURPOSE: While most coronavirus disease 2019 (COVID-19) cases are mild, the risk of heart dysfunction remains unknown. The objective of this observational study was to assess the impact of mild COVID-19 on heart function in a short-term follow-up using advanced echocardiography. METHODS: Our study cohort comprised patients diagnosed with COVID-19 who did not require hospitalization. Speckle tracking echocardiography (STE) was used to assess heart chambers function in the 31 recovered COVID-19 patients, and the results were compared with those of the control group (28 healthy participants). RESULTS: Left ventricular (LV) and right ventricular (RV) systolic function was assessed using standard and STE methods and was found to be normal and comparable in both groups (LV ejection fraction [p = 0.075], LV global longitudinal strain [p = 0.123], LV global radial strain [p = 0.630], LV global circumferential strain [p = 0.069], tricuspid annular plane systolic excursion [p = 0.417], tricuspid S' peak systolic velocity [p = 0.622], and RV free wall longitudinal strain [p = 0.749]). Similarly, atrial function was not impacted when assessed using advanced STE. CONCLUSIONS: The heart function of patients with mild COVID-19 symptoms, assessed using standard and advanced echocardiographic methods, was observed to be normal after a short-term follow-up.