Pulmonary Hypertension (PH) due to Pulmonary Embolism (PE) secondary to COVID19 - A District General Hospital(DGH) experience from the UK

ABSTRACT

Introduction: Primitive data suggest prevalence of PH in patients with COVID19 is around 13% but prognosis is unclear. Approximately 0.5-2% of patients develop CTEPH after acute PE and recommendation is to screen them for CTEPH if remains symptomatic at 3/12 after PE. Aim(s) The primary aim of the study was to assess the chances of persistent PH following PE secondary to COVID19 Methods: We conducted a retrospective cohort study at a DGH in the UK. All patients diagnosed with COVID-19 and PE between April, 2020 to October, 2021 were examined. Patients were divided into two groups . COVID19 and PE with co-morbidities(excluding pre existing PH) . COVID19 and PE without co-morbidities We compared the prevalence of pulmonary hypertension between the two groups on cardiac ECHO (defined as a mean pulmonary arterial pressure >= 25mmHg) at the time of diagnosis of PE and at 3 months following treatment. Result(s) 80 patients were included in the study (49 with co-morbidities & 31 with no co-morbidities). Average age of co-morbidities and no comorbidities groups were 73yrs and 70yrs respectively. Average PaO2/FiO2 ratio for comorbidities and no co-morbidities groups were 170 and 195 respectively. 14 patients (13 with co-morbidities & 1 no co-morbidity) died in total. Results showed that relative risk of persistent PH and subsequent mortality following PE in COVID19 is 4.16 times & 1.32 times more in co-morbidties group as compared to no co-morbidties group respectively (p<0.001) Conclusion(s) Patients with co-morbidities are at high risk of persistent PH and mortality due to PE secondary to COVID19 and should be worked up for CTEPH if PH exist on 3/12 ECHO.