Abstract 18350: COVID-19 Patients With Pulmonary Hypertension Hospitalized in the United States During the Early Pandemic: Analysis of In-Hospital Mortality, Clinical Outcomes, and Racial Disparities

Introduction: Coronavirus Disease 2019 (COVID-19) has been associated with adverseoutcomes among hospitalized patients with pulmonary hypertension (PH) based onlimited studies. The objective of our retrospective study was to utilize theNational Inpatient Sample (NIS) database to compare in-hospital mortality andother secondary clinical outcomes between COVID-19 patients with PH andCOVID-19 patients without PH.

Hypothesis: We hypothesizedthat there would be a significant increase in inpatient mortality and othercomplications among hospitalized COVID-19 patients with PH.

Methods: Patientsages 18 years and older admitted to a hospital in the United States betweenJanuary 1, 2020 and December 31, 2020 with COVID-19 were included in our studyand stratified into two cohorts.

Results: Aftermultivariate adjustment, we found that COVID-19 patients with PH hadsignificantly higher in-hospital mortality, increased lengths of stay, andhigher costs of hospitalization when compared to COVID-19 patients without PH.We also noted that COVID-19 with PH had increased dependence on invasive andnon-invasive positive pressure ventilation suggestive of more severerespiratory failure. Furthermore, our data demonstrated that COVID-19 patientswith PH were at risk of pulmonary embolism and myocardial infarction. Also,Hispanic and Native American COVID-19 patients with PH remained at anindependently elevated risk for in-hospital mortality when compared to otherracial groups.

Conclusions: To our knowledge this isthe largest study evaluating outcomes among COVID-19 patients with PH.In-hospital complications, especially pulmonary embolism, present a clinicalmechanism for the observed inpatient mortality. Given the significant mortalityand complications associated with COVID-19 infection and pulmonaryhypertension, we recommend vaccination against SARS-CoV-2 and aggressivenon-pharmacologic preventative measures.