The paradox of pulmonary arterial hypertension in Italy in the COVID-19 era: is risk of disease progression around the corner?
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Badagliacca Roberto, Papa Silvia, D'Alto Michele, Ghio Stefano, Agostoni Piergiuseppe, Ameri Pietro, Argiento Paola, Brunetti Natale Daniele, Casamassima Vito, Casu Gavino, Cedrone Nadia, Confalonieri Marco, Corda Marco, Correale Michele, D'Agostino Carlo, De Michele Lucrezia, Famoso Giulia, Galgano Giuseppe, Greco Alessandra, Lombardi Carlo Mario, Manzi Giovanna, Madonna Rosalinda, Mercurio Valentina, Mulè Massimiliano, Paciocco Giuseppe, Romaniello Antonella, Romeo Emanuele, Scelsi Laura, Serra Walter, Stolfo Davide, Toma Matteo, Vatrano Marco, Vitulo Patrizio, Vizza Carmine Dario, italian Pulmonary Hypertension NETwork (iPHNET)
Аннотация
MATERIALS AND METHODS: The present study, which included 25 Italian centres, considered demographic data, the number of in-person visits, 6-min walk and echocardiographic test results, brain natriuretic peptide/N-terminal pro-brain natriuretic peptide test results, World Health Organization functional class assessment, presence of elective and non-elective hospitalisation, need for treatment escalation/initiation, newly diagnosed PAH, incidence of COVID-19 and mortality rates. Data were collected, double-checked and tracked by institutional records between March 1 and May 1, 2020, to coincide with the first peak of COVID-19 and compared with the same time period in 2019.
RESULTS: Among 1922 PAH patients, the incidences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 were 1.0% and 0.46%, respectively, with the latter comparable to that in the overall Italian population (0.34%) but associated with 100% mortality. Less systematic activities were converted into more effective remote interfacing between clinicians and PAH patients, resulting in lower rates of hospitalisation (1.2% versus 1.9%) and related death (0.3% versus 0.5%) compared with 2019 (p<0.001). A high level of attention is needed to avoid the potential risk of disease progression related to less aggressive escalation of treatment and the reduction in new PAH diagnoses compared with 2019.
CONCLUSION: A cohesive partnership between healthcare providers and regional public health officials is needed to prioritise PAH patients for remote monitoring by dedicated tools.