Abstract
The incidence of COVID-19 infection in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is similar to that in the general population, but the mortality rate is much higher. COVID-19 vaccination is strongly recommended for PAH/CTEPH patients. The aim of our cross-sectional study was to identify reasons why PAH/CTEPH patients refused vaccination against COVID-19. Moreover, we assessed the safety profile of approved COVID-19 vaccines in PAH/CTEPH patients. We examined 261 patients (164 PAH patients and 97CTEPH patients) with a median age of 60 (18–92) years, 62% of which were female. Sixty-one patients (23%) refused to be vaccinated. The main reason for unwillingness to be vaccinated was anxiety about adverse events (AEs, 61%). Age and fear of COVID-19 in the univariate analysis and age ≥60 years in the multivariate regression analysis were factors that impacted willingness to be vaccinated (OR = 2.5; p = 0.005). AEs were reported in 61% of vaccinated patients after the first dose and in 40.5% after the second dose (p = 0.01). The most common reported AEs were pain at the injection site (54.5%), fever (22%), fatigue (21%), myalgia (10.5%), and headache (10%). A lower percentage of AEs was reported in older patients (OR = 0.3; p = 0.001). The COVID-19 vaccines are safe for PAH/CTEPH patients. The results obtained in this study may encourage patients of these rare but severe cardio-pulmonary diseases to get vaccinated against COVID-19.
Highlights
Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare severe diseases that lead to progressive right heart failure and death if left untreated
The inclusion criteria for the study were over 18 years of age and diagnosis of PAH or CTEPH confirmed by right heart catheterization and other necessary tests according to the current guidelines [1]
A total of 261 PAH/CTEPH patients were enrolled in the study
Summary
Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare severe diseases that lead to progressive right heart failure and death if left untreated. PAH (group 1 of clinical classification of pulmonary hypertension) is characterized by precapillary pulmonary hypertension and elevated vascular resistance on right heart catheterization [1,2]. PAH patients receive specific drugs that decrease their pulmonary arterial pressure and may reverse right heart remodeling and slow down progression of the disease. Chronic thromboembolic pulmonary hypertension (group 4 of clinical classification of pulmonary hypertension) is characterized by the presence of thromboembolic material in pulmonary arteries. Chronic obstruction of the pulmonary arteries leads to increased pulmonary arterial pressure and development of precapillary pulmonary hypertension [1]. Some CTEPH patients may need additional specific drugs to slow down the progression of the disease [1,3,4]
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