A survey-based estimate of COVID-19 incidence and outcomes among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension and impact on the process of care

Joshua D. Lee, Charles D. Burger, Genecelle B. Delossantos, Daniel Grinnan, David D. Ralph, Sam G. Rayner, John J. Ryan, Zeenat Safdar, Corey E. Ventetuolo, Roham T. Zamanian, Peter J. Leary

Research output: Contribution to journalArticle

Abstract

Rationale: Patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) typically undergo frequent clinical evaluation. The incidence and outcomes of coronavirus disease (COVID-19) and its impact on routine management for patients with pulmonary vascular disease is currently unknown. Objectives: To assess the cumulative incidence and outcomes of recognized COVID-19 for patients with PAH/CTEPH followed at accredited pulmonary hypertension centers, and to evaluate the pandemic's impact on clinic operations at these centers. Methods: A survey was e-mailed to program directors of centers accredited by the Pulmonary Hypertension Association. Descriptive analyses and linear regression were used to analyze results. Results: Seventy-seven center directors were successfully e-mailed a survey, and 58 responded (75%). The cumulative incidence of COVID-19 recognized in individuals with PAH/CTEPH was 2.9 cases per 1,000 patients, similar to the general U.S. population. In patients with PAH/CTEPH for whom COVID-19 was recognized, 30% were hospitalized and 12% died. These outcomes appear worse than the general population. A large impact on clinic operations was observed including fewer clinic visits and substantially increased use of telehealth. A majority of centers curtailed diagnostic testing and a minority limited new starts of medical therapy. Most centers did not use experimental therapies in patients with PAH/CTEPH diagnosed with COVID-19. Conclusions: The cumulative incidence of COVID-19 recognized in patients with PAH/CTEPH appears similar to the broader population, although outcomes may be worse. Although the total number of patients with PAH/CTEPH recognized to have COVID-19 was small, the impact of COVID-19 on broader clinic operations, testing, and treatment was substantial.

Original languageEnglish (US)
Pages (from-to)1576-1582
Number of pages7
JournalAnnals of the American Thoracic Society
Volume17
Issue number12
DOIs
StatePublished - Dec 2020

Keywords

  • COVID-19
  • Clinic operations
  • Outcomes
  • Telehealth

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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