| Title: |
Chronic thromboembolic pulmonary hypertension is an uncommon complication of COVID-19: UK national surveillance and observational screening cohort studies |
| Authors: |
Reddy, SA; Newman, J; Leavy, OC; Ghani, H; Pepke-Zaba, J; Cannon, JE; Sheares, KK; Taboada, D; Bunclark, K; Lawrie, A; Sudlow, CL; Berry, C; Wild, JM; Mitchell, JA; Quint, J; Rossdale, J; Price, L; Howard, LS; Wilkins, M; Sattar, N; Chowienczyk, P; Thompson, R; Wain, LV; Horsley, A; Ho, L-P; Chalmers, JD; Marks, M; Poinasamy, K; Raman, B; Harris, VC; Houchen-Wolloff, L; Brightling, CE; Evans, RA; Toshner, MR; PHOSP-COVID Study Collaborative Group |
| Publisher Information: |
European Respiratory Society |
| Publication Year: |
2024 |
| Collection: |
Imperial College London: Spiral |
| Subject Geographic: |
England |
| Description: |
Introduction Pulmonary embolism (PE) is a well-recognised complication of 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 NT pro-BNP. 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, 4 (1.2%) patients were identified to have CTEPH potentially associated with COVID-19 PE, and a further 3 (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 |
| Language: |
English |
| Relation: |
European Respiratory Journal; http://hdl.handle.net/10044/1/113911 |
| DOI: |
10.1183/13993003.01742-2023 |
| Availability: |
http://hdl.handle.net/10044/1/113911; https://doi.org/10.1183/13993003.01742-2023 |
| Rights: |
Copyright ©The authors 2024. http://creativecommons.org/licenses/by/4.0/ This version is distributed under the terms of the Creative Commons Attribution Licence 4.0. ; https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.C8E0F4CD |
| Database: |
BASE |