The clinical course of chronic thromboembolic pulmonary hypertension after COVID-19.

The COVID-19 (COronaVIrus Disease 2019) caused more than 3.5 million deaths all over the world. Patients who have underlying comorbidity, such as cardiovascular and pulmonary diseases have shown worse prognosis. In view of this, undivided attention was focused on patients with such rare conditions as pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). There is currently limited data available regarding COVID-19 infection in CTEPH patients. The available data are mostly case studies or small case series. The aim of this publication was to describe the course of COVID-19 in patients with previously diagnosed CTEPH. Methods. The study included 92 patients with an established diagnosis of CTEPH, who were managed in the Federal State Budgetary Institution National medical research center of cardiology named after academician E.I.Chazov, Ministry of Health of the Russian Federation. 62 patients with CTEPH and confirmed COVID-19 were enrolled, including 62% women. The mean age was 55.8 +/- 14.8 years. Results. The duration of COVID-19 was 14 [10;30] days. The fever, general weakness, anosmia, and dyspnea were the most frequent presentations at diagnosis of COVID-19 in CTEPH patients. According to the multispiral computed tomography (CT) chest scans, more than half of the patients (54.2%) had mild disease (category CT-1). Most of the patients were under specific therapy (92%), mainly riociguat at an average daily dose of 5.75 +/- 2.2 mg/day. All patients received anticoagulants. No need for long-term respiratory support and no lethal outcomes were registered in the study group. Conclusion. Small pilot studies demonstrated favorable clinical course of COVID-19 in CTEPH patients. This finding could be explained by the protective effect of anticoagulation and specific treatment.Copyright © 2022 Valieva Z.S. et al.

The clinical course of chronic thromboembolic pulmonary hypertension after COVID-19

The COVID-19 (COronaVIrus Disease 2019) caused more than 3.5 million deaths all over the world. Patients who have underlying comorbidity, such as cardiovascular and pulmonary diseases have shown worse prognosis. In view of this, undivided attention was focused on patients with such rare conditions as pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). There is currently limited data available regarding COVID-19 infection in CTEPH patients. The available data are mostly case studies or small case series. The aim of this publication was to describe the course of COVID-19 in patients with previously diagnosed CTEPH. Methods. The study included 92 patients with an established diagnosis of CTEPH, who were managed in the Federal State Budgetary Institution National medical research center of cardiology named after academician E.I.Chazov, Ministry of Health of the Russian Federation. 62 patients with CTEPH and confirmed COVID-19 were enrolled, including 62% women. The mean age was 55.8 ± 14.8 years. Results. The duration of COVID-19 was 14 [10;30] days. The fever, general weakness, anosmia, and dyspnea were the most frequent presentations at diagnosis of COVID-19 in CTEPH patients. According to the multispiral computed tomography (CT) chest scans, more than half of the patients (54.2%) had mild disease (category CT-1). Most of the patients were under specific therapy (92%), mainly riociguat at an average daily dose of 5.75 ± 2.2 mg/day. All patients received anticoagulants. No need for long-term respiratory support and no lethal outcomes were registered in the study group. Conclusion. Small pilot studies demonstrated favorable clinical course of COVID-19 in CTEPH patients. This finding could be explained by the protective effect of anticoagulation and specific treatment.

["Guiding lights" for the diagnosis of chronic thromboembolic pulmonary hypertension in the flow of patients with pulmonary embolism].

On December 13, 2021, an expert council was held to determine the position of experts of different specialties regarding the reasons for the low level of diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) in real clinical practice in a pandemic of a new coronavirus infection and possible ways to improve detection in patients with pulmonary embolism (PE) ) in history. The reasons for the low level of diagnosis of CTEPH are the insufficient level of knowledge of specialists, especially primary care physicians; lack of clear regulatory documents and expert centers for the management of this category of patients. Primary diagnosis of CTEPH in a pandemic can be strengthened through the widespread use of telemedicine for consultations of primary care physicians with specialists from expert centers; to maximize the role of echocardiography and computed tomography (CT) as differential diagnostic tools for dyspnea, in particular in patients with COVID-19. To increase the detection rate of CTEPH, diagnostic vigilance is required in patients with risk factors and episodes of venous thromboembolism. To improve the screening of CTEPH, it is necessary to create an algorithm for monitoring patients who have had PE; provide educational activities, including through the media; create materials for patients with accessible information. The regulatory documents should designate the circle of responsible specialists who will be engaged in long-term monitoring of patients with PE. Educational programs are needed for primary care physicians, cardiologists, and other physicians who come into the field of view of patients with CTEPH; introduction of a program to create expert centers for monitoring and managing patients with the possibility of performing ventilation-perfusion lung scintigraphy, cardiopulmonary stress test, CT, right heart catheterization. It seems important to build cooperation with the Ministry of Health of Russia in order to create special protocols, procedures for managing patients with PE and CTEPH.

Case report of mild form of a new coronavirus infection in patient with idiopathic pulmonary hypertension.

The article presents a clinical case of mild novel coronavirus infection COVID-19 complicated with bilateral interstitial pneumonia in a female patient with idiopathic pulmonary hypertension.

[Pulmonary arterial hypertension: achievements and realities of modern treatment, a look into the future].

The paper summarizes the most important aspects of modern treatment of patients with pulmonary arterial hypertension (PAH): the goals of therapy are indicated, the issues of risk stratification of PAH progression/mortality, the place of combination specific therapy and switching strategies are considered, as well as new promising approaches to therapy; features of the course of the new coronavirus infection COVID-19 in this category of patients are discussed.