Abstract
Abstract Introduction The SARS-CoV-2 pandemic had a significant impact on mortality in the group of patients (pts) with pulmonary hypertension (PH). Specific therapies offer the potential to improve COVID-19 survival in this vulnerable population, but data on COVID-19 mortality according to specific PH therapies are scarce. Aim To assess mortality in the course of COVID-19 among pts diagnosed with PH, treated under the Polish ministry therapeutic program and registered in the national BNP-PL database, according to the intensity of specific PH therapy used in Poland. Methods We analyzed the records of the complete population of Polish pts treated under the National Drug Program of PH (PAH and CTEPH) and registered in the national database of BNP-PL from 01 March 2020 to 31 August 2022. The clinical severity of COVID-19 course and mortality were reviewed. Clinical characteristics of infected and deceased patients were compared in relation to the specific therapy used. Results The analysis included 188 pts with SARS-CoV-2 infection (mean age 59 ± 17,7 years; 61% female). 45 patients (24%) required hospitalization. Mortality rate was 18% (34/188, including 15 out-of-hospital deaths) vs. 2,6% for estimated in the general population. Those who died due to COVID-19 were slightly older (mean age 63 ± 18.4 vs. 58 ± 17.5 yrs; p=0,13). There was no significant difference in mortality in subsets receiving monotherapy (13.8%), 2 drugs (25.4%) or 3 drugs(15%)- p=0.18. There was a trend towards higher mortality in pts on double regimen. Pts treated with prostacyclin analogues had significantly higher risk of dying from COVID-19 (30% vs 11.4% in others, p=0.002). Conclusions COVID-19 infection in pulmonary hypertension pts was related to high mortality and prostacyclin analogues users are at highest risk. Considering that this analysis suggests that COVID-19 mortality was equalized between less sick patients suitable for monotherapy and those qualified for double/triple regimens. The finding of numerically highest risk in double therapy users might signify needs for earlier escalation to triple regimen.Characteristics of pts with PH and Covid
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