Abstract 10384: Impact of Preexisting Pulmonary Hypertension on Outcomes in Patients Hospitalized With Covid-19

Abstract

Introduction: Pulmonary hypertension (PH) is commonly associated with cardiopulmonary co-morbidities that increase morbidity and mortality risk with COVID-19. Hypothesis: This study aims to evaluate the association between preexisting PH and in-hospital outcomes in patients admitted with COVID-19. Methods: Consecutive patients at a large New England academic health system hospitalized with COVID-19 between March 1 and December 31, 2020, who had prior echocardiograms with documented estimated right ventricular systolic pressure (RVSP) were included. PH was defined as RVSP ≥30 mm Hg. Multivariable logistic regression adjusting for demographic and clinical characteristics was employed to relate PH to a primary outcome of all-cause mortality, and secondary outcomes including non-invasive positive pressure ventilation (NIPPV), myocardial infarction (MI), intensive care unit admission (ICU), and recurrent heart failure (HF) individually. Results: Of the 656 patients admitted, 395 (60.2%) had documented PH on a prior echocardiogram. PH patients were older, more likely to be men, and have cardiopulmonary and renal disease. Patients with PH had larger atrial size and higher E to early diastolic mitral annular tissue velocity (E/e') but similar left ventricular and right ventricular function compared to patients without PH. All-cause mortality (21% vs 10.3%, p= 0.001), need for ICU level of care (19% vs 13%, p = 0.046), NIPPV (23% vs 16%, p = 0.03), and recurrent HF (18% vs 5%, p < 0.001) were more common in patients with PH compared to those without. Unadjusted and adjusted odds ratios relating PH to study outcomes appear in the Table . Conclusions: Preexisting PH is independently associated with higher risk of all-cause mortality in patients who are hospitalized with COVID-19.