Is There any Association Between Lung Involvement Severity and Pulmonary Blood Pressure in Patients with COVID-19

Background: Pulmonary hypertension (PH) has emerged as a potential complication in patients with COVID-19, with growing evidence suggesting an association between PH and disease severity and outcomes. Objectives: This study aimed to investigate the relationship between the severity of pulmonary involvement and the incidence of PH in COVID-19 patients admitted to Ayatollah Rohani Hospital in Babol, Iran. Methods: This retrospective cohort study included 200 patients with a confirmed COVID-19 diagnosis. Comprehensive transthoracic echocardiography was performed to assess pulmonary artery pressure (PAP) and tricuspid regurgitation velocity (TRV), as well as other echocardiographic parameters such as tricuspid annular plane systolic excursion (TAPSE) and right ventricular size. Patients were classified into two groups based on the presence or absence of PH, defined by elevated PAP and TRV values. Demographic data, clinical characteristics, CT total severity scores, and outcomes were compared between the two groups using appropriate statistical tests. Results: Among the 200 patients included in the study, 39 (19.5%) were diagnosed with PH based on echocardiographic findings. The presence of PH was associated with a significantly higher mortality rate (12.8% vs. 3.1%, P = 0.013). Interestingly, no significant differences were observed in total severity scores (TSS), TAPSE, or right ventricular wall thickness between the two groups, suggesting that the development of PH may be independent of these factors. Conclusions: The findings of this study demonstrate that the severity of pulmonary involvement, as assessed by CT total severity score, is not associated with the development of PH in COVID-19 patients. Furthermore, the presence of PH is linked to a higher mortality rate, highlighting the importance of early detection and the implementation of appropriate management strategies for PH in this patient population. Early identification and monitoring of PH through routine echocardiographic screening may contribute to improved outcomes in COVID-19 patients.