The paradox of pulmonary arterial hypertension in Italy in the COVID-19 era: is risk of disease progression around the corner?

被引：10

作者：

Badagliacca, Roberto ^{[1
]}

Papa, Silvia ^{[1
]}

D'Alto, Michele ^{[2
]}

Ghio, Stefano ^{[3
]}

Agostoni, Piergiuseppe ^{[4
,5
]}

Ameri, Pietro ^{[6
]}

Argiento, Paola ^{[2
]}

Brunetti, Natale Daniele ^{[6
]}

Casamassima, Vito ^{[7
]}

Casu, Gavino ^{[8
,9
]}

Cedrone, Nadia ^{[10
]}

Confalonieri, Marco ^{[11
]}

Corda, Marco ^{[12
]}

Correale, Michele ^{[13
]}

D'Agostino, Carlo ^{[14
]}

De Michele, Lucrezia ^{[14
]}

Famoso, Giulia ^{[15
]}

Galgano, Giuseppe ^{[7
]}

Greco, Alessandra ^{[3
]}

Lombardi, Carlo Mario ^{[16
]}

Manzi, Giovanna ^{[1
]}

Madonna, Rosalinda ^{[17
]}

Mercurio, Valentina ^{[18
]}

Mule, Massimiliano ^{[19
]}

Paciocco, Giuseppe ^{[20
]}

Romaniello, Antonella ^{[21
]}

Romeo, Emanuele ^{[2
]}

Scelsi, Laura ^{[3
]}

Serra, Walter ^{[22
]}

Stolfo, Davide ^{[23
]}

Toma, Matteo ^{[24
,25
]}

Vatrano, Marco ^{[26
]}

Vitulo, Patrizio ^{[27
]}

Vizza, Carmine Dario ^{[1
]}

机构：

[1] Sapienza Univ Rome, Dept Cardiovasc & Resp Sci, Rome, Italy

[2] Monaldi Hosp Univ L Vanvitelli, Dept Cardiol, Naples, Italy

[3] Fdn IRCCS Policlin S Matteo, Pavia, Italy

[4] Univ Milan, Dept Clin & Community Sci, Milan, Italy

[5] IRCCS, Ctr Cardiol Monzino, Milan, Italy

[6] Univ Foggia, Dept Med & Surg Sci, Foggia, Italy

[7] F Miulli Hosp, Dept Cardiol, Bari, Italy

[8] San Francesco Hosp Nuoro, ATS Sardegna ASSL Nuoro, Nuoro, Italy

[9] Univ Sassari, Sassari, Italy

[10] Osped S Pertini, Unita Med Interna, Rome, Italy

[11] Univ Hosp Cattinara, Heart Thorax Vessels Dept, Pulmonol Unit, Trieste, Italy

[12] Azienda Osped G Brotzu San Michele, Cardiol Unit, Cagliari, Italy

[13] Osped Riuniti Univ Hosp, Dept Cardiol, Foggia, Italy

[14] Univ Hosp Policlin Consorziale Bari, Dept Cardiol, Bari, Italy

[15] Dept Cardiac Thorac Vasc Sci & Publ Hlth Padua, Padua, Italy

[16] Univ Brescia, Cardiol, Brescia, Italy

[17] Univ Pisa UNIPI, Dept Surg Med & Mol Pathol & Crit Sci, Cardiol Unit, Pisa, Italy

[18] Univ Naples Federico II, Dept Translat Med Sci, Naples, Italy

[19] Ferrarotto Hosp, Catania, Italy

[20] Azienda Osped San Gerardo, Cardio Thoraco Vasc Dept, Clin Pneumol, Monza, Italy

[21] S Andrea Hosp, Cardiol Unit, Rome, Italy

[22] Univ Hosp Parma, Cardiol Unit, Parma, Italy

[23] Azienda Sanit Univ Giuliano Isontina, Cardiovasc Dept, Trieste, Italy

[24] IRCCS Osped Policlin San Martino, Cardiovasc Dis Unit, Genoa, Italy

[25] Univ Genoa, Dept Internal Med, Genoa, Italy

[26] Azienda Osped Pugliese Ciaccio Catanzaro, Catanzaro, Italy

[27] IRCCS Ist Mediterraneo Trapianti & Terapie Ad Alt, Pulmonol Unit, Palermo, Italy

来源：

EUROPEAN RESPIRATORY JOURNAL | 2022年 / 60卷 / 04期

关键词：

MYOCARDIAL-INFARCTION; INTERVENTION; POPULATION;

D O I：

10.1183/13993003.02276-2021

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Objective The coronavirus disease 2019 (COVID-19) outbreak has led to significant restrictions on routine medical care. We conducted a multicentre nationwide survey of patients with pulmonary arterial hypertension (PAH) to determine the consequences of governance measures on PAH management and risk of poor outcome in patients with COVID-19.Materials and methods The present study, which included 25 Italian centres, considered demographic data, the number of in-person visits, 6-min walk and echocardiographic test results, brain natriuretic peptide/N-terminal pro-brain natriuretic peptide test results, World Health Organization functional class assessment, presence of elective and non-elective hospitalisation, need for treatment escalation/initiation, newly diagnosed PAH, incidence of COVID-19 and mortality rates. Data were collected, double-checked and tracked by institutional records between March 1 and May 1, 2020, to coincide with the first peak of COVID-19 and compared with the same time period in 2019.Results Among 1922 PAH patients, the incidences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 were 1.0% and 0.46%, respectively, with the latter comparable to that in the overall Italian population (0.34%) but associated with 100% mortality. Less systematic activities were converted into more effective remote interfacing between clinicians and PAH patients, resulting in lower rates of hospitalisation (1.2% versus 1.9%) and related death (0.3% versus 0.5%) compared with 2019 (p<0.001). A high level of attention is needed to avoid the potential risk of disease progression related to less aggressive escalation of treatment and the reduction in new PAH diagnoses compared with 2019.Conclusion A cohesive partnership between healthcare providers and regional public health officials is needed to prioritise PAH patients for remote monitoring by dedicated tools.

引用

页数：11

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