Understanding the current status of patients with pulmonary hypertension during COVID-19 outbreak: a small-scale national survey from China

Zhou H, Zhang G, Deng X, Jin B, Qiu Q, Yan M, Wang X, Zheng X.Pulm Circ. 2020 May 18;10(2):2045894020924566. doi: 10.1177/2045894020924566. eCollection 2020 Apr-Jun.PMID: 32523686 Free PMC article.



Pulmonary hypertension is a chronic disease developing progressively with high mortality. Pulmonary hypertension patients need persistent medical care; however, limited reports focused on them when there was an outbreak of coronavirus disease 2019 in China. This national survey was aimed to evaluate the overall condition of pulmonary hypertension patients during this period. A questionnaire regarding the living condition of pulmonary hypertension patients during coronavirus disease 2019 was designed by pulmonary hypertension diagnostic experts in Wuhan Asia Heart Hospital. Pulmonary hypertension patients and their family members were invited to participate in this survey online. One-hundred twenty pulmonary hypertension patients and 23 family members participated in the survey; 64.8% (n = 87) participants came from Hubei, and others were from 15 other provinces; 98.6% (n = 141) participants were in home quarantine; 65.8% (n = 79) were pulmonary arterial hypertension associated with congenital heart disease; and 76.7% (n = 92) patients proclaimed their heart function was well maintained at class I or II. One (0.8%) patient was confirmed severe acute respiratory syndrome coronavirus 2 infection. Two (1.7%) patients were hospitalized due to heart function worsening. Nearly 70% (n = 100) participants implied shortage in medications during coronavirus disease 2019 outbreak. A total of 24.2% (n = 29) patients indicated that medications were discontinued due to the insufficient supply. Most of the participants stayed optimistic on either coronavirus disease 2019 outbreak or their pulmonary hypertension disease, and 61.7% (n = 74) patients would go to the hospital for follow-up immediately after outbreak. These preliminary data show pulmonary hypertension patients are able to avoid severe disease when they are in home quarantine. Medication supplement is important for pulmonary hypertension patients when their heart function is well maintained. In addition, there might be increasing requirements of medical care for pulmonary hypertension patients after the outbreak.



Fig. 1. Participants distribution. (a) Diagram shows the numbers of participants from different provinces/cities; 60.8% (n = 87) participants came from Hubei, among which 29.9% (n = 26) were from Wuhan. (b) Geographical distribution of the participants is illustrated in heatmap. The map is used to present the participants distribution only, not intended for anything else. PH: pulmonary hypertension.


Fig. 2. New onset symptoms. Incidences of new onset symptoms based on multiple in questionnaire are presented. Most patients and family participants reported unchanged in disease progression. Fatigue and less active were more reported in patients (20% vs 0, p = 0.026). “Others” included sleep not well, chest pain, aching pain in limbs, and catching a cold but recovered.


Fig. 3. Medication utilization of PH patients. Utilization of medications is illustrated in percentage according to the answers from patients and family participants respectively. Bosentan, Ambrisentan, Tadalafil, and Sildenafil were most commonly used medications; 57.5% (n = 69) patients and 60.9% (n = 14) family participants chose Ambrisentan while using other medications.


Fig. 4. Medication supplement during COVID-19 outbreak. (a) Target treatment during outbreak. Pies of different color present the actual utilization of medications depending on whether there was a shortage. (b) Participants attitude on medication supplement. Different pies present how participants felt for medication supplement during COVID-19 outbreak.


Fig. 5. Psychologic status of participants during COVID-19 outbreak. (a) Advanced questions to understand mental status of participants. (b) Feelings to COVID-19 of patients and family participants according to their questionnaires. COVID-19: coronavirus disease 2019; PH: pulmonary hypertension.