Abstract 19002: Impact of Pulmonary Hypertension on Covid-19 Pneumonia Hospitalizations: Analysis of The National Inpatient Sample 2020

Background: SARS-CoV-2 swept across the globe, overwhelming healthcare systems across the world regardless of borders and socioeconomic factors. COVID pneumonia (CP) can result in ARDS and increased pulmonary artery pressures. Pulmonary hypertension (PHT) is generally a chronic cardiopulmonary disease that is associated with progressive vascular remodeling. We aimed to assess the impact of underlying PHT on CP patients with a large sample size.

Methods: We utilized the National Inpatient Sample from 2020 to identify 1,058,815 hospitalized adults with CP. These hospitalizations were further stratified based on the presence of PHT. A multivariate regression model was used to adjust for confounders and analyze the variables.

Results: Of those who were admitted for CP, 24,284 (2.3%) had PHT. In-hospital mortality was higher in those with PHT (19.6% vs 10.9%; p<0.001). Figure 1 shows the Forrest plot for multivariate analysis of in-hospital outcomes when adjusted for patient demographics, comorbidities, and hospital characteristics. When adjusted similarly, CP patients with PHT had longer length of stay (LOS) by 1.3 days (p<0.001) and had additional hospital costs (HC) of $23,232 (p<0.001).

Conclusions: CP patients who had PHT had significantly worse outcomes in terms of in-hospital mortality, LOS, HC, cardiac arrest, arrhythmias, sepsis, cardiogenic shock, and being intubated. These patients are unable to tolerate the ventilation-perfusion mismatch and the rise in pulmonary arterial pressures seen in ARDS.