Incidence and Outcomes of Covid-19 in Patients With Pulmonary Hypertension: A Systematic Review and Meta-Analysis Publisher



A Akbari ABOLFAZL ; S Hadizadeh SHIVA ; L Heidary LEIDA ; A Baniasad AMIR ; S Hejazi SEPIDEH ; F Vakilian FARVEH ; S Attaran SOROUSH ; Dm Attaran Davoud M
Source: Current Respiratory Medicine Reviews Published:2025

Abstract

Background: The aim of this study is to systematically review and analyze the incidence and outcomes of COVID-19 in patients with pulmonary hypertension (PH). Methods: We searched PubMed, SCOPUS, Web of Science, and Embase for relevant publications up to March 27th, 2024. Articles were screened for studies on the incidence or outcomes of COVID-19 in PH patients. Screening, data extraction, and risk of bias assessment were performed independently in duplicate. When possible, relevant results were pooled using the random effects model. Results: Of the 5,981 articles, a total of 30 were included in the systematic review and 29 in the meta-analysis. The incidence rate of COVID-19 in PH patients was 25 (15-41) per 100,000 person-day. The hospitalization rate was 47% (26.4-68.7), and the mean duration of hospitalization was 10.033 (9.644-10.422) ± 0.198 days. The rate of admission to the intensive care unit was 35.8% (23.9-49.9) and mechanical ventilation was required in 17.4% (11.6-25.3) of hospitalized patients. The in-hospital mortality rate was 23.1% (21.6-24.6). Further analysis of studies comparing COVID-19 patients with and without PH showed a higher mortality rate in COVID-19 patients with PH (OR = 1.722 CI 95% (1.393-2.128), P < 0.0001, I2 = 99%). Meta-regression showed no significant association between sex and the incidence of COVID-19 infection in PH patients. Conclusion: Pre-existing PH may not be associated with a higher incidence of COVID-19 but may be associated with worsening outcomes of COVID-19 infection. © 2025 Elsevier B.V., All rights reserved.