| Title: |
Chronic thromboembolic pulmonary hypertension is an uncommon complication of COVID-19: UK national surveillance and observational screening cohort studies. |
| Authors: |
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; 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 |
| Publisher Information: |
European Respiratory Society (ERS); Department of Medicine Student; Department of Medicine; //doi.org/10.1183/13993003.01742-2023 |
| Publication Year: |
2024 |
| Collection: |
Apollo - University of Cambridge Repository |
| Subject Terms: |
Humans; COVID-19; United Kingdom; Hypertension; Pulmonary; Female; Pulmonary Embolism; Male; Middle Aged; Aged; Chronic Disease; SARS-CoV-2; Cohort Studies; Incidence; Adult; Hospitalization |
| Description: |
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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
Electronic-Print; application/pdf |
| Language: |
English |
| Relation: |
https://www.repository.cam.ac.uk/handle/1810/376484 |
| Availability: |
https://www.repository.cam.ac.uk/handle/1810/376484 |
| Rights: |
Attribution 4.0 International (CC BY 4.0) ; https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.84CFDC68 |
| Database: |
BASE |