Pulmonary Circulation (Apr 2020)

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

  • John J. Ryan,
  • Lana Melendres-Groves,
  • Roham T. Zamanian,
  • Ronald J. Oudiz,
  • Murali Chakinala,
  • Erika B. Rosenzweig,
  • Mardi Gomberg-Maitland

DOI
https://doi.org/10.1177/2045894020920153
Journal volume & issue
Vol. 10

Abstract

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The COVID-19 pandemic presents many unique challenges when caring for patients with pulmonary hypertension. The COVID-19 pandemic has altered routine standard of care practice and the acute management particularly for those patients with pulmonary arterial hypertension, where pulmonary arterial hypertension-specific treatments are used. It is important to balance the ongoing care and evaluation of pulmonary arterial hypertension 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 pulmonary arterial hypertension therapies, for example in a patient with high-likelihood of pulmonary arterial hypertension, then it remains important to complete the thorough evaluation. However, the COVID-19 outbreak may also represent a unique time when pulmonary hypertension experts have to weigh the risks and benefits of the diagnostic work-up including potential exposure to COVID-19 versus initiating targeted pulmonary arterial hypertension therapy in a select high-risk, high likelihood World Symposium Pulmonary Hypertension Group 1 pulmonary arterial hypertension patients. This document will highlight some of the issues facing providers, patients, and the pulmonary arterial hypertension 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.