- Published
- 29 August 2024
- Journal article
Chronic thromboembolic pulmonary hypertension is an uncommon complication of COVID-19: UK national surveillance and observational screening cohort studies
- Authors
-
- Source
- European Respiratory Journal
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.
Rights
Copyright ©The authors 2024. This version is distributed under the terms of the Creative Commons Attribution Licence 4.0.
Cite as
Reddy, S., Newman, J., Leavy, O., Ghani, H., Pepke-Zaba, J., Cannon, J., Sheares, K., Taboada, D., Bunclark, K., Lawrie, A., Sudlow, C., Berry, C., Wild, J., Mitchell, J., Quint, J., Rossdale, J., Price, L., Howard, L., Wilkins, M., Sattar, N., Chowienczyk, P., Thompson, R., Wain, L., Horsley, A., Ho, L., Chalmers, J., Marks, M., Poinasamy, K., Raman, B., Harris, V., Houchen-Wolloff, L., Brightling, C., Evans, R. & Toshner, M. 2024, 'Chronic thromboembolic pulmonary hypertension is an uncommon complication of COVID-19: UK national surveillance and observational screening cohort studies', European Respiratory Journal, 64(2), article no: 2301742. https://doi.org/10.1183/13993003.01742-2023