31 March 2020

Care of patients with pulmonary arterial hypertension during the coronavirus (Covid-19) pandemic

Abstract

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The COVID-19 pandemic presents many unique challenges when caring for patients with pulmonary hypertension (PH).

The COVID-19 pandemic has altered routine standard of care practice and the acute management particularly for those patients with pulmonary arterial hypertension (PAH), where PAH-specific treatments are used. It is important to balance the ongoing care and evaluation of PAH patients with “exposure risk” to COVID-19 for patients coming to clinic or the hospital. If there is a morbidity and mortality benefit from starting PAH therapies, for example in a patient with high-likelihood of PAH, then it remains important to complete the thorough evaluation.

However, the COVID-19 outbreak may also represent a unique time when PH experts have to weigh the risks and benefits of the diagnostic work-up including potential exposure to COVID-19 versus initiating targeted PAH therapy in a select high-risk, high likelihood World Symposium Pulmonary Hypertension (WSPH) Group 1 PAH patients.

This document will highlight some of the issues facing providers, patients and the PAH community in real-time as the COVID-19 pandemic is evolving and is intended to share expected common clinical scenarios and best clinical practices to help the community at-large.

Key contributors

John J. Ryan1, Lana Melendres-Groves2, Roham T. Zamanian3, Ronald J. Oudiz4, Murali Chakinala5, Erika B. Rosenzweig6, Mardi Gomberg-Maitland7.

  1. Division of Cardiovascular Medicine, Department of Medicine, University of Utah, Salt Lake City, UT, USA.
  2. Division of Pulmonary and Critical Care Medicine, University of New Mexico, Albuquerque, NM, USA.
  3. Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA.
  4. Division of Cardiology, Lundquist Institute for Biomedical Innovation & Research at Harbor– UCLA Medical Center, Torrance, California, USA.
  5. Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
  6. Division of Pediatric Cardiology, Columbia University College of Physicians & Surgeons, New York, NY, USA.
  7. Division of Cardiovascular Medicine, George Washington University Medicine and Health Sciences, Washington, DC, USA.

Topics

Mechanical Ventilation and Gas Exchange
Pulmonary Hypertension
Right Heart Failure
prostacyclin


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