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.
John J. Ryan1, Lana Melendres-Groves2, Roham T. Zamanian3, Ronald J. Oudiz4, Murali Chakinala5, Erika B. Rosenzweig6, Mardi Gomberg-Maitland7.
- Division of Cardiovascular Medicine, Department of Medicine, University of Utah, Salt Lake City, UT, USA.
- Division of Pulmonary and Critical Care Medicine, University of New Mexico, Albuquerque, NM, USA.
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA.
- Division of Cardiology, Lundquist Institute for Biomedical Innovation & Research at Harbor– UCLA Medical Center, Torrance, California, USA.
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
- Division of Pediatric Cardiology, Columbia University College of Physicians & Surgeons, New York, NY, USA.
- Division of Cardiovascular Medicine, George Washington University Medicine and Health Sciences, Washington, DC, USA.