Abstract 15636: Effect of COVID-19 Public Health Measures on Activity and Quality of Life in Patients With Pulmonary Arterial Hypertension

Abstract

Background: Limitation of physical activity has been widely enforced to reduce COVID-19 transmission, however it is a critical measure in the prevention of cardiovascular disease. In patients with pulmonary arterial hypertension (PAH), exercise capacity relates to clinical outcomes and exercise training improves cardiopulmonary function. Here, we describe the temporal effects of UK government restriction measures on daily activity and quality of life (QoL) in patients with PAH. Methods: Patients Enrolled in The United Kingdom National Cohort Study of Idiopathic and Heritable PAH Study were implanted with insertable cardiac monitors (LinQ, Medtronic) in the clinic setting. Data were transmitted and reviewed in accordance with established clinical protocols. Standard questionnaires were administered remotely to assess QoL (EmPHasis-10), anxiety (GAD-7) and depression (PHQ-9). Results: Median age of the 26 patients was 49 years, 23 (88%) were female and 5 (19%) had heritable PAH with mutations in BMPR2. At enrolment 10 (38.5%) patients were low risk (<5% 1-year mortality), 10 (38.5%) were intermediate risk (5-10%) and 6 (23%) were high risk (>10%). The mean duration from insertion to census date was 21.1 weeks (SD 5.7). No complications were reported. Completeness of remote monitoring data was 100%. Following lockdown, mean activity was reduced compared to pre-lockdown levels (3.16 vrs 2.68 hours/day, -0.48 hours, 95%CI -0.27- -0.69, 16%, p<0.0001). This reduction was present each week following lockdown. Although not statistically significant the greatest reduction in activity was observed in patients in the low-risk group. Following lockdown QoL was reduced (26 (18-38) vrs 32 (17-47), p<0.01) and anxiety (1 (0-9) vrs 10 (5-18), p<0.001) and depression scores increased (3 (1-16) vrs 11 (3-17), p<0.001) compared to pre-lockdown levels. No change in day or night heart rate, or heart rate variability was observed and no patients developed COVID-19. Conclusion: In this cohort of patients with PAH, protective health measures were effective in preventing COVID-19 in patients thought to be highly vulnerable. However, these measures resulted in reduced daily activity and QoL and were associated increased anxiety and depression indicators.