Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, 08661 Vilnius, Lithuania.
Clinic of Chest Diseases, Immunology and Allergology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, 03101 Vilnius, Lithuania.
Medicina (Kaunas). 2024 Apr 30;60(5):750. doi: 10.3390/medicina60050750.
COVID-19 infection has a significant burden on global morbidity and mortality, especially in elderly people and in patients with chronic respiratory and cardiovascular diseases, such as pulmonary hypertension (PH). We aimed to evaluate the impact of COVID-19 infection on patients diagnosed with severe chronic PH. A single-center prospective cohort study was performed. Patients were enrolled from 1 November 2020 to 31 December 2022. Follow-up was until 31 December 2023. Data were collected on PH diagnosis, clinical presentation, outcomes, brain natriuretic peptide (BNP) levels, pulmonary function test with lung diffusion capacity for carbon monoxide (DLCO), and computed tomography pulmonary angiography (CTPA) analysis. During the 26 months of our study, 51 PH patients were diagnosed with COVID-19 infection. The majority, 44 (86.3%) of all COVID-19 infected patients, were treated on an outpatient basis, and 7 (13.7%) required hospitalization. During the follow-up period, 8 (15.7%) patients died: 4 (7.8%) due to complications of COVID-19 infection, and the other 4 (7.8%) died in the later stages of the follow-up period after recovery from acute COVID-19 infection. Therefore, the in-hospital mortality in our study was 43% ( = 3). As mentioned above, the overall mortality was 7.8% ( = 4). Higher BNP levels in the third month after COVID-19 were associated with higher mortality rates ( = 0.028). Lung function, including DLCO, did not significantly worsen with COVID-19. In our study, 24 patients (47.1%) were referred for a follow-up CTPA scan and one of them developed typical fibrotic lung changes after COVID-19. The incidence of COVID-19 infection in patients diagnosed with PH was 34%. In our patients with severe chronic PH, the overall mortality rate due to COVID-19 infection was low. Pulmonary fibrosis was a rare complication in our cohort. COVID-19 infection in severe PH may increase the risk of worsening chronic heart failure.
COVID-19 感染对全球发病率和死亡率有重大影响，尤其是在老年人和患有慢性呼吸道和心血管疾病（如肺动脉高压[PH]）的患者中。我们旨在评估 COVID-19 感染对确诊为严重慢性 PH 的患者的影响。进行了一项单中心前瞻性队列研究。患者于 2020 年 11 月 1 日至 2022 年 12 月 31 日入组。随访至 2023 年 12 月 31 日。收集 PH 诊断、临床表现、结局、脑利钠肽（BNP）水平、肺功能一氧化碳弥散量（DLCO）和计算机断层肺动脉造影（CTPA）分析数据。 在我们的研究期间的 26 个月中，51 名 PH 患者被诊断为 COVID-19 感染。所有 COVID-19 感染患者中，44 名（86.3%）接受了门诊治疗，7 名（13.7%）需要住院治疗。在随访期间，有 8 名（15.7%）患者死亡：4 名（7.8%）死于 COVID-19 感染的并发症，另 4 名（7.8%）在急性 COVID-19 感染后恢复的随访后期死亡。因此，本研究中的住院死亡率为 43%（=3）。如上所述，总死亡率为 7.8%（=4）。COVID-19 后第三个月的 BNP 水平较高与死亡率较高相关（=0.028）。肺功能（包括 DLCO）在 COVID-19 后并未明显恶化。在本研究中，24 名患者（47.1%）接受了后续 CTPA 扫描，其中 1 名患者在 COVID-19 后出现典型纤维化肺改变。 PH 患者 COVID-19 感染的发生率为 34%。在我们患有严重慢性 PH 的患者中，COVID-19 感染导致的死亡率较低。肺纤维化是本队列中的罕见并发症。严重 PH 中的 COVID-19 感染可能会增加慢性心力衰竭恶化的风险。
