Connect with others who understand.

sign up log in
About myPHteam

Pulmonary Hypertension (PH) and COVID-19

Posted on June 29, 2020

Article written by
Heather Lapidus Glassner

Medically reviewed by
Vinicio de Jesus Perez, M.D.

    • COVID-19 can be particularly deadly for people with pulmonary hypertension (PH) or pulmonary arterial hypertension (PAH), whose lung function is already compromised.
    • Avoiding exposure to the coronavirus by physical distancing is the best way to stay safe.
    • Some PH treatments may also be used to treat COVID-19, but it is unknown whether they protect those with PH from the coronavirus.
    • Unlike PH flare-ups, COVID-19 usually causes coughing and fevers, as well as fatigue.

    Members of myPHteam have voiced concerns about their risks of experiencing serious complications if they contract COVID-19, the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition, people with pulmonary hypertension or pulmonary arterial hypertension may wonder how to tell the difference between a typical PH flare-up and the symptoms of COVID-19.

    To get answers to members’ questions about COVID-19, myPHteam conducted an interview with Dr. Vinicio de Jesus Perez, a staff physician at the Stanford Adult PH Clinic and an associate professor of pulmonary, allergy, and critical care medicine at Stanford University School of Medicine.

    Why Is COVID-19 a Serious Concern for People With PH?

    According to the U.S. Centers for Disease Control and Prevention (CDC), people of any age with serious underlying health conditions have a higher risk for developing severe illness from coronavirus infections. According to Dr. de Jesus Perez, those with chronic lung disease — including high blood pressure in the pulmonary arteries — may be especially at risk.

    “It's no secret that COVID-19 is an infectious disease that has a strong affinity for the respiratory system,” said Dr. de Jesus Perez. ”Patients with chronic lung disorders are already a vulnerable population. Many of our patients live at the edge of maximum reserve of what their heart and lungs can deal with.”

    Dr. de Jesus Perez went on to explain how the coronavirus enters the respiratory system, resulting in an inflammatory response that disrupts the body’s access to oxygen. “So, if you put that now in the context of somebody who's got a chronic lung disorder — be it IDF [idiopathic pulmonary fibrosis], COPD [chronic obstructive pulmonary disease], pulmonary hypertension — these patients are already living on the edge, because their systems are already working at max capacity to keep the vital processes going. Well, it's a recipe for disaster. We're very, very anxious about our patients. Because if they're exposed to this, there's a very high proportion of patients that will die.”

    Avoiding Exposure to COVID-19

    According to an April 29 article in Pulmonary Circulation, “Currently, the most challenging aspect of ongoing care of PAH patients is considering ‘exposure risk’ for patients coming to the clinic or hospital for follow-up and new appointments, including routine laboratory tests.” The goal is to keep people safe when they come in for doctors’ appointments or treatments.

    When possible, doctors are rescheduling appointments, procedures, and diagnostic tests. Fortunately, some members of myPHteam have been able to push out testing and procedures to avoid exposure risk. One member reported, “I have a virtual appointment with my PH doctor this Wednesday. We will be rescheduling my heart cath. It had been cancelled due to COVID-19.” Another said, “I saw the pulmonologist yesterday. Due to COVID-19, he's unable to do the tests he wants. He scheduled it three months out.”

    Dr. de Jesus Perez emphasized the importance of following physical distancing guidelines. “We are very, very aggressive about encouraging our patients to stay indoors, protect themselves with masks and hand sanitation. Most importantly, stay sheltered in place until things normalize.” He acknowledged that it’s impossible to predict how long the situation will last. “We just don't know when that time is going to be, so [staying home] is our strongest recommendation right now.”

    Members of myPHteam understand the need for social distancing from others. As one member said, “I have stayed at home for three months per my doctor's orders. I have been out a couple of times in the last two weeks, but I wear my mask and stay 6 feet away from people.” Another member recognized that it is not easy to stay quarantined, but that it’s worth it. He wrote, “Quarantine is hard sometimes, but the alternative is deadly.”

    Dr. de Jesus Perez pointed out how seriously the PH community has taken COVID-19 and met the challenges of physical distancing. “I think the major reason why we haven't seen many PH patients walk through the doors [with COVID-19] is because they are taking our advice. They're staying indoors and observing all the precautions that are in place to keep people from getting the disease.”

    Is It a PH Flare-Up or COVID-19?

    Researchers have identified a growing list of COVID-19 symptoms in what was initially believed to be primarily a respiratory illness. Some of the symptoms the CDC initially listed as COVID-19 symptoms (particularly shortness of breath) could easily be mistaken for symptoms of PH flare-ups. How can people with PH tell the difference between a flare-up and COVID-19?

    Dr. de Jesus Perez described the difference between coronavirus symptoms and PH flare-ups. “I think one of the telltale signs [of COVID-19] is that they are likely to have a significant cough. They're going to have acute fatigue. They can have fevers, and they can feel chest tightness.” In this scenario, he noted, “It is really not subtle, and many patients will immediately call us, get screened, or come to the hospital to be seen acutely.”

    In summary, Dr. de Jesus Perez described the situation that will trigger a doctor to suspect coronavirus in someone with PH: “The biggest red flag will be, ‘I was feeling fine. Now I am coughing, I feel this overwhelming fatigue, and I have this fever.’ In the context of the COVID epidemic, that [situation is considered] COVID until proven otherwise.”

    Doctors may want to test to confirm the diagnosis. Members of myPHteam have experienced their doctors’ cautious approach firsthand. One member reported, “I had to get tested for COVID-19 because I'm still having breathing issues. ... Doctors want me tested just to be sure. I feel good and sincerely doubt I have it. I also had a chest X-ray to help find out what's causing being unable to breathe during a shower or walking just half a block.”

    PH Medications and COVID-19

    One question people with PH may have is whether common medications prescribed for pulmonary hypertension might provide protection against the impact of COVID-19. Experts do not yet have enough information about this, and won’t know more until they have had a chance to study COVID-19 and PH in depth and over time.

    It is true that certain medications sometimes prescribed for PH or PAH are being studied for use in the treatment of COVID-19. Brigham and Women’s Hospital lists Veletri (Epoprostenol) as one of the potential treatments for hypoxemia (low levels of oxygen) in cases of COVID-19. On May 6, STAT published an article about the use of anticoagulants such as Coumadin (Warfarin). Researchers reported better outcomes when providers added anticoagulants to treatment options for COVID-19 patients.

    According to Dr. de Jesus Perez, “There's been discussion in the medical community that some [PH] medications may actually have some benefit since they work as vasodilators, which means they can potentially keep vessels open and help drive blood to areas of the lungs that are still getting oxygenation. On the other hand, this can also be damaging, because you may be driving blood to areas of the lung that are actually not working appropriately. We are very careful to make any assumptions that our patients are being protected by medications.”

    Stay Up-to-Date and Connected

    Advice from the CDC is changing on a daily or weekly basis. Check the latest updates regularly for changes.

    It’s important to stay connected. Speaking on the phone or video chat may not replace hugs and in-person visits, but connecting with friends or loved ones can help minimize feelings of isolation. As always, myPHteam offers a support group more than 27,000 strong, where other people facing PH or PAH are available online.

    Do you have more questions about how COVID-19 might impact you and others living with pulmonary hypertension? Ask your questions in the comments below.

    References

    1. Symptoms of Coronavirus — CDC
    2. Care of patients with pulmonary arterial hypertension during the coronavirus (COVID-19) pandemic — Pulmonary Circulation
    3. CDC Adds 6 Symptoms To Its COVID-19 List — NPR
    4. Coronavirus (COVID-19) — Centers for Disease Control and Prevention
    5. COVID-19 Protocols (Respiratory) — Brigham and Women’s Hospital
    6. Giving blood thinners to severely ill Covid-19 patients is gaining ground — STAT
    7. Situation Summary — CDC
    8. COVID-19 and Pulmonary Hypertension — Pulmonary Hypertension Association (PHA)
    9. Coronavirus disease (COVID-19) pandemic — World Health Organization (WHO)

    Heather has over two decades of experience in market research. She has conducted social listening and quantitative survey research across a variety of conditions. Learn more about her here.

    Dr. Vinicio de Jesus Perez, Dr. Vinicio de Jesus Perez received his M.D. from the University of Puerto Rico Medical School and completed an internal medicine residency at Massachusetts General Hospital. Learn more about him here.

    A myPHteam Member said:

    Thanks for the information

    posted 22 days ago

    hug

    Recent articles

    Bsp af 5
    Thousands of members of myPHteam connect with one another and read each other's stories to gain...

    Three Books About Pulmonary Hypertension You Should Read

    Thousands of members of myPHteam connect with one another and read each other's stories to gain...
    Ph vs pah difference
    Article written by Nyaka Mwanza Pulmonary hypertension (PH) commonly occurs among the general...

    PAH vs. PH: What's the Difference?

    Article written by Nyaka Mwanza Pulmonary hypertension (PH) commonly occurs among the general...
    Myphteam howtomakeonlinehealthwork carousel
    Article written by Kelly Crumrin Telemedicine is the use of two-way communication technology to...

    Telemedicine and PAH: How to Make Online Health Care Work for You

    Article written by Kelly Crumrin Telemedicine is the use of two-way communication technology to...
    Losing weight and ph
    Article written by Annie Keller Pulmonary hypertension causes a decrease of blood flow to the...

    Managing Weight Gain and Pulmonary Hypertension

    Article written by Annie Keller Pulmonary hypertension causes a decrease of blood flow to the...
    Msl fb myphteam kevin
    I’ve come to a place of appreciation with pulmonary arterial hypertension, commonly referred to...

    Member Spotlight: Pulmonary Arterial Hypertension, My New Reality

    I’ve come to a place of appreciation with pulmonary arterial hypertension, commonly referred to...
    Myphteam carousel what is pah
    Article written by Laurie Berger Pulmonary arterial hypertension (PAH) is a specific type of...

    What Is Pulmonary Arterial Hypertension (PAH)?

    Article written by Laurie Berger Pulmonary arterial hypertension (PAH) is a specific type of...
    Myphteam carousel pulmonary arterial hypertension diagnosis and treatments
    Article written by Laurie Berger Diagnosing PAH is a process of elimination – other diseases and...

    Pulmonary Arterial Hypertension (PAH) Diagnosis and Treatments

    Article written by Laurie Berger Diagnosing PAH is a process of elimination – other diseases and...
    Coronavirus
    Article written by Kelly Crumrin According to the Centers for Disease Control and Prevention...

    Canceling Is Kindness: Keeping Safe From COVID-19 With Pulmonary Hypertension (PH)

    Article written by Kelly Crumrin According to the Centers for Disease Control and Prevention...
    Mht ad types thumb
    Article written by Kelly Crumrin The World Health Organization (WHO) classifies the five main...

    Types of Pulmonary Hypertension

    Article written by Kelly Crumrin The World Health Organization (WHO) classifies the five main...
    Mht ad cause thumb
    Article written by Kelly Crumrin Pulmonary hypertension (PH) can be caused by anything that...

    What Causes Pulmonary Hypertension?

    Article written by Kelly Crumrin Pulmonary hypertension (PH) can be caused by anything that...
    myPHteam My pulmonary hypertension Team

    Two Ways to Get Started with myPHteam

    Become a Member

    Connect with others who are living with pulmonary hypertension. Get members only access to emotional support, advice, treatment insights, and more.

    sign up

    Become a Subscriber

    Get the latest articles about pulmonary hypertension sent to your inbox.

    Not now, thanks

    Privacy policy
    myPHteam My pulmonary hypertension Team

    Thank you for signing up.

    close