Reddy, S Ashwin; Newman, Joseph; Leavy, Olivia C; Ghani, Hakim; Pepke-Zaba, Joanna; Cannon, John E; Sheares, Karen K; Taboada, Dolores; Bunclark, Katherine; Lawrie, Allan; +25 more... Sudlow, Cathie L; Berry, Colin; Wild, James M; Mitchell, Jane A; Quint, Jennifer; Rossdale, Jennifer; Price, Laura; Howard, Luke S; Wilkins, Martin; Sattar, Naveed; Chowienczyk, Philip; Thompson, Roger; Wain, Louise V; Horsley, Alexander; Ho, Ling-Pei; Chalmers, James D; Marks, Michael; Poinasamy, Krisnah; Raman, Betty; Harris, Victoria C; Houchen-Wolloff, Linzy; Brightling, Christopher E; Evans, Rachael A; Toshner, Mark R; PHOSP-COVID Study Collaborative Group; (2024) Chronic thromboembolic pulmonary hypertension is an uncommon complication of COVID-19: UK national surveillance and observational screening cohort studies. The European respiratory journal, 64 (2). p. 2301742. ISSN 0903-1936 DOI: https://doi.org/10.1183/13993003.01742-2023
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Abstract
BACKGROUND: Pulmonary embolism (PE) is a well-recognised complication of coronavirus disease 2019 (COVID-19) infection, and chronic thromboembolic pulmonary disease with and without pulmonary hypertension (CTEPD/CTEPH) are potential life-limiting consequences. At present the burden of CTEPD/CTEPH is unclear and optimal and cost-effective screening strategies yet to be established. METHODS: We evaluated the CTEPD/CTEPH referral rate to the UK national multidisciplinary team (MDT) during the 2017-2022 period to establish the national incidence of CTEPD/CTEPH potentially attributable to COVID-19-associated PE with historical comparator years. All individual cases of suspected CTEPH were reviewed by the MDT for evidence of associated COVID-19. In a separate multicentre cohort, the risk of developing CTEPH following hospitalisation with COVID-19 was calculated using simple clinical parameters at a median of 5 months post-hospital discharge according to existing risk scores using symptoms, ECG and N-terminal pro-brain natriuretic peptide. RESULTS: By the second year of the pandemic, CTEPH diagnoses had returned to the pre-pandemic baseline (23.1 versus 27.8 cases per month; p=0.252). Of 334 confirmed CTEPD/CTEPH cases, four (1.2%) patients were identified to have CTEPH potentially associated with COVID-19 PE, and a further three (0.9%) CTEPD without PH. Of 1094 patients (mean age 58 years, 60.4% male) hospitalised with COVID-19 screened across the UK, 11 (1.0%) were at high risk of CTEPH at follow-up, none of whom had a diagnosis of CTEPH made at the national MDT. CONCLUSION: A priori risk of developing CTEPH following COVID-19-related hospitalisation is low. Simple risk scoring is a potentially effective way of screening patients for further investigation.
Item Type | Article |
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Faculty and Department | Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
PubMed ID | 39060016 |
Elements ID | 227538 |
Official URL | http://dx.doi.org/10.1183/13993003.01742-2023 |
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