Abstract Purpose Pulmonary hypertension is a rare complication of COVID-19, in the absence other common causes of pulmonary hypertension. We hypothesize that COVID 19, primarily an illness affecting the lung parenchyma triggering inflammation, and hence might also attribute to significant pulmonary hypertension. Methods We conducted a cross-sectional study to examine the association between COVID-19 infection and pulmonary hypertension, using All of Us database version 8. The study included 341,382 participants who agreed to share their electronic health records. COVID-19 status and pulmonary hypertension were defined using ICD-9/10 codes. Statistical analyses included chi-square tests for categorical variables, t-tests for continuous variables, and multivariable logistic regression adjusted for age, race, ethnicity, and sex. We excluded patients with systemic lupus erythematosus, congestive heart failure and pulmonary embolism as they were known to cause pulmonary hypertension. Results The study population included 30,760 COVID-19 positive and 310,622 COVID-19 negative individuals. COVID-19 positive patients were slightly older (mean age 57.7 ± 16.0 vs 55.7 ± 16.7 years, p 0.001) and more likely to be female (66.0% vs 61.6%, p 0.001). The prevalence of pulmonary hypertension was significantly higher in COVID-19 positive patients compared to COVID-19 negative patients (0.9% vs 0.5%, p 0.001). In unadjusted analysis, COVID-19 infection was associated with increased odds of pulmonary hypertension (OR 2.04, 95% CI: 1.79-2.32, p 0.001). After adjusting for demographic factors, the association remained significant (aOR 1.92, 95% CI: 1.69-2.18, p 0.001). Age was strongly associated with pulmonary hypertension risk, with individuals aged 65+ years showing the highest risk compared to those 18-34 years (aOR 9.33, 95% CI: 7.00-12.78, p 0.001). Black race (aOR 1.34, 95% CI: 1.18-1.52, p 0.001) and male sex (aOR 0.74, 95% CI: 0.67-0.82, p 0.001) were also significantly associated with pulmonary hypertension risk in the adjusted model. Clinical Implication COVID-19 is an independent risk factor for pulmonary hypertension, even after adjusting for demographics. Older age and Black race are also linked to higher risk. Therefore, patients in these groups diagnosed with COVID-19 should be screened for pulmonary hypertension to enable timely intervention, reduce morbidity and mortality, and lower healthcare costs by shortening hospital and ICU stays. This abstract is funded by: None
Chirackal et al. (Fri,) studied this question.