Chronic thromboembolic pulmonary hypertension is an uncommon complication of COVID-19: UK national surveillance and observational screening cohort studies.

Autor:	Reddy SA; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.; University of Cambridge, Cambridge, UK.; Joint first authors., Newman J; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.; University of Cambridge, Cambridge, UK.; Joint first authors., Leavy OC; University of Leicester, Leicester, UK.; NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK., Ghani H; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.; University of Cambridge, Cambridge, UK., Pepke-Zaba J; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK., Cannon JE; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK., Sheares KK; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK., Taboada D; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK., Bunclark K; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK., Lawrie A; Sheffield Teaching NHS Foundation Trust and University of Sheffield, Sheffield, UK., Sudlow CL; University of Edinburgh, Edinburgh, UK., Berry C; NHS Greater Glasgow and Clyde Health Board, and University of Glasgow, Glasgow, UK., Wild JM; Sheffield Teaching NHS Foundation Trust and University of Sheffield, Sheffield, UK., Mitchell JA; Imperial College London, London, UK., Quint J; Imperial College London, London, UK., Rossdale J; Guy's and St Thomas' NHS Foundation Trust, London, UK., Price L; Imperial College London, London, UK.; Royal Brompton Hospital, London, UK., Howard LS; Imperial College London, London, UK., Wilkins M; Imperial College London, London, UK., Sattar N; NHS Greater Glasgow and Clyde Health Board, and University of Glasgow, Glasgow, UK., Chowienczyk P; Royal Brompton Hospital, London, UK., Thompson R; Sheffield Teaching NHS Foundation Trust and University of Sheffield, Sheffield, UK., Wain LV; NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK., Horsley A; Manchester University NHS Foundation Trust and University of Manchester, Manchester, UK., Ho LP; University of Oxford, Oxford, UK., Chalmers JD; NHS Tayside and University of Dundee, Dundee, UK., Marks M; London School of Hygiene and Tropical Medicine, London, UK., Poinasamy K; Asthma UK and British Lung Foundation Partnership, London, UK., Raman B; University of Oxford, Oxford, UK., Harris VC; University of Leicester, Leicester, UK., Houchen-Wolloff L; University of Leicester, Leicester, UK., Brightling CE; NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK., Evans RA; NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK., Toshner MR; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK mrt34@medschl.cam.ac.uk.; University of Cambridge, Cambridge, UK.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2024 Aug 29; Vol. 64 (2). Date of Electronic Publication: 2024 Aug 29 (Print Publication: 2024).
DOI:	10.1183/13993003.01742-2023
Abstrakt:	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. Competing Interests: Conflict of interest: J.D. Chalmers has received research grants from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Gilead Sciences, Grifols, Novartis, Insmed and Trudell; received consultancy or speaker fees from Antabio, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Insmed, Janssen, Novartis, Pfizer, Trudell and Zambon; and is Chief Editor of the European Respiratory Journal. The remaining authors have no potential conflicts of interest to disclose. (Copyright ©The authors 2024.)
Databáze:	MEDLINE
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