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Article Dans Une Revue American Journal of Respiratory and Critical Care Medicine Année : 2022

COVID-19 in Patients with Pulmonary Hypertension: A National Prospective Cohort Study

Jason Weatherald
Xavier Jaïs
  • Fonction : Auteur
Sophie Bulifon
  • Fonction : Auteur
Elise Noel-Savina
  • Fonction : Auteur
Ana Nieves
  • Fonction : Auteur
Sébastien Renard
  • Fonction : Auteur
Hélène Bouvaist
  • Fonction : Auteur
Marianne Riou
  • Fonction : Auteur
Pascal de Groote
  • Fonction : Auteur
Pamela Moceri
  • Fonction : Auteur
Nicolas Favrolt
  • Fonction : Auteur
Anne Guillaumot
  • Fonction : Auteur
Antoine Beurnier
  • Fonction : Auteur
Athénaïs Boucly
Nathan Ebstein
  • Fonction : Auteur
Mitja Jevnikar
  • Fonction : Auteur
Jérémie Pichon
  • Fonction : Auteur
Sophia Keddache
  • Fonction : Auteur
Mariana Preda
  • Fonction : Auteur
Anne Roche
  • Fonction : Auteur
Sabina Solinas
  • Fonction : Auteur
Andrei Seferian
  • Fonction : Auteur
Vincent Cottin
Ahmad Kais
  • Fonction : Auteur
Artaud-Macari Elise
  • Fonction : Auteur
Chaouat Ari
  • Fonction : Auteur
Dauphin Surnameclaire
  • Fonction : Auteur
Gaudoin Anne
  • Fonction : Auteur
Hascoet Sébastien
  • Fonction : Auteur
Horeau-Langlard Delphine
  • Fonction : Auteur
Inamo Jocelyn
  • Fonction : Auteur
Magro Pascal
  • Fonction : Auteur
Meurice Jean-Claude
  • Fonction : Auteur
Poubeau Patrice
  • Fonction : Auteur
Prevot Grégoire
  • Fonction : Auteur
Rosario Roger
  • Fonction : Auteur

Résumé

Rationale: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with pulmonary endothelial dysfunction. There are limited data available on the outcomes of coronavirus disease (COVID-19) in patients with pulmonary hypertension (PH), a disease characterized by pulmonary endothelial dysfunction. Objectives: To describe characteristics and outcomes of patients with precapillary PH and COVID-19. Methods: We prospectively collected characteristics, management, and outcomes of adult patients with precapillary PH in the French PH network who had COVID-19 between February 1, 2020, and April 30, 2021. Clinical, functional, and hemodynamic characteristics of PH before COVID-19 were collected from the French PH registry. Measurements and Main Results: A total of 211 patients with PH (including 123 with pulmonary arterial hypertension, 47 with chronic thromboembolic PH, and 41 with other types of PH) experienced COVID-19, and 40.3% of them were outpatients, 32.2% were hospitalized in a conventional ward, and 27.5% were in an ICU. Among hospitalized patients (n = 126), 54.0% received corticosteroids, 37.3% high-flow oxygen, and 11.1% invasive ventilation. Right ventricular and acute renal failure occurred in 30.2% and 19.8% of patients, respectively. Fifty-two patients (all hospitalized) died from COVID-19. Overall mortality was 24.6% (95% CI [confidence interval], 18.8-30.5) and in-hospital mortality 41.3% (95% CI, 32.7-49.9). Nonsurvivors were significantly older, more frequently male and suffering comorbidities (diabetes, chronic respiratory diseases, systemic hypertension, chronic cardiac diseases, and/or chronic renal failure), and had more severe PH at their most recent evaluation preceding COVID-19 diagnosis (in terms of functional class and 6-minute-walk distance; all P < 0.05). Use of pulmonary arterial hypertension therapy was similar between survivors and nonsurvivors. Conclusions: COVID-19 in patients with precapillary PH was associated with a high in-hospital mortality. The typical risk factors for severe COVID-19 and severity of PH were associated with mortality in this population.
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hal-03810260 , version 1 (02-06-2023)

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David Montani, Marie-Caroline Certain, Jason Weatherald, Xavier Jaïs, Sophie Bulifon, et al.. COVID-19 in Patients with Pulmonary Hypertension: A National Prospective Cohort Study. American Journal of Respiratory and Critical Care Medicine, 2022, 206 (5), pp.573-583. ⟨10.1164/rccm.202112-2761OC⟩. ⟨hal-03810260⟩
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