Pulmonary arterial hypertension and COVID-19: Piecing the puzzle - 27/10/23

Doi : 10.1016/j.resmer.2023.101053

Fida Charif ^a,^⁎,^{^{1
These authors contributed equally to the manuscript.}} , Fatima Dakroub ^b,^c,^{^{1
These authors contributed equally to the manuscript.}}, Imad Bou Akl ^d, Mithum Kularatne ^e, David Montani ^f,^g,^h
^a Pulmonology Division, Hopitaux du Léman, Thonon les bains, France
^b Department of Experimental Pathology, Immunology and Microbiology, American University of Beirut, Beirut, Lebanon
^c Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
^d Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
^e University of Calgary, Calgary, Canada
^f Université Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France
^g INSERM UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies», Hôpital Marie Lannelongue, Le Plessis Robinson, France
^h AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France

^⁎Corresponding author at: Pulmonary division, Hopitaux du Léman, Thonon les bains, France.Pulmonary divisionHopitaux du LémanThonon les bainsFrance

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Abstract

COVID-19 remains a health care concern despite the end of the pandemic. Patients with cardiovascular disease (CVD) are at a higher risk for developing severe COVID-19 complications. Studies investigating the COVID-19 clinical characteristics in pulmonary arterial hypertension (PAH) patients have reported discordant conclusions so far. In this review, we summarize the literature pertaining to the clinical presentation of COVID-19 in patients with PAH. In addition, we discuss common pathological aspects and disease mechanisms between PAH and COVID-19. We present an overview of the different types of PAH-approved therapy and their potential utilization as a treatment in the context of COVID-19. Moreover, we summarize the clinical trials that assessed the safety and efficiency of PAH-approved drugs in COVID-19 patients. Finally, we conclude with proposals for prospective research studies.

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Keywords : Pulmonary arterial hypertension, COVID-19, PAH-approved therapy, PAH-COVID-19 interaction, Clinical course

Abbreviations : AA, ADAM17, ARDS, ACE2, c-AMP, cGMP, CVD, CTD-PAH, CTEPH, ET-1, ERA, ICU, iPAH, IPF, mACE2, MV, NF-kB, NO, PAH, PASMCs, PDE-5, PE, PH, PVR, RAAS, s-ACE2, SARS-CoV-2, SCTA, SOFA, RAAS

Plan

The shared pathobiology between PAH and COVID-19

The role of angiotensin converting enzyme 2 (ACE2)

Endothelial dysfunction

The clinical lessons from COVID-19 and PAH

Clinical outcomes of COVID-19 in PAH patients

The long-term effects of COVID-19 on the pulmonary vasculature

Repurposing PAH-approved therapy for COVID-19 treatment

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Vol 84

Article 101053- novembre 2023 Retour au numéro

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Pulmonary arterial hypertension and COVID-19: Piecing the puzzle - 27/10/23

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