Abstract 15745: Health Outcomes in Pulmonary Arterial Hypertension Patients With COVID-19: A Real-world Analysis

Abstract

Introduction: Patients with underlying chronic conditions, including PAH, are predicted to have worse outcomes with COVID-19. This analysis aimed to assess the impact of COVID-19 on outcomes in PAH patients. Methods: Over a 5-month period starting 1/1/2020, PAH patients with COVID-19 were compared to PAH patients without COVID-19. In addition, COVID-19 patients with and without PAH were analyzed. Differences in all-cause mortality, all-cause hospitalization, and need for mechanical ventilation (MV) at any time after COVID-19 diagnosis were evaluated. Similar analyses were performed between subgroups of hospitalized patients. PAH and COVID-19 patients were identified by ICD and CPT codes along with PAH-specific medications from the TriNetX Dataworks Network of 35 international healthcare organizations. Cohorts were compared using unmatched and propensity-matched data (PMH, demographics, labs, and non-PAH medications) with categorical variables evaluated using χ 2 /Fisher’s Exact tests. Results: A total cohort of 566 patients were identified with a diagnosis of PAH; 510 without COVID-19 and 56 with COVID-19. In PAH patients with COVID-19, there were significantly higher rates of all-cause mortality, all-cause hospitalization, and need for MV (p<0.00001) compared to PAH patients without COVID-19. Mortality in the PAH with COVID-19 cohort was 16% compared to 2% in the PAH group without COVID-19. After matching, significance was maintained in all-cause hospitalization (P=0.0013) and need for MV (P=0.0009). Adjusting for disease severity examining only matched all-cause hospitalized patients, death and need for MV was significantly higher in the PAH patients with COVID-19. When comparing PAH patients with COVID-19 versus a matched COVID-19 cohort without PAH, there were no differences in any evaluated outcomes. Conclusions: This real-world analysis demonstrates that PAH patients with COVID-19 have worse outcomes, including a higher rate of all-cause mortality at 5 months, compared to PAH patients without COVID-19. Additionally, no differences were observed between COVID-19 patients with or without PAH. In a subset of patients with more severe disease that were hospitalized, the results were consistent to those from the overall cohort.