key: cord-0950529-tpgqomno
authors: Magoon, Rohan
title: The pulmonary circuit dynamics in COVID-19!
date: 2020-10-31
journal: J Anesth
DOI: 10.1007/s00540-020-02869-6
sha: f0e2de64cd81e8de6bae0ad36360a7c091177b82
doc_id: 950529
cord_uid: tpgqomno

nan

I read with interest the article by Hirata and Yamakage, focusing the cardiovascular considerations of COVID-19 [1] , motivating me to elucidate the underemphasized pulmonary vascular consequences.

While cytokine storm and microcirculatory dysfunction contribute to pulmonary hypertension (PH) in COVID (accentuated by hypoxemia, mechanical ventilation), impact on outcomes is concerning. Pagnesi et al. evaluated 200 COVID-19 patients, to reveal a 12% PH incidence, associated with 41.7% adverse outcome (mortality/ICU admission) compared to 8.5% in those without PH [2] . COVID in preexisting PH also accounted for 12% mortality in a US-based survey [3] . Moreover, PH-setting is prone to right ventricular failure with inflammatory myocardial depression worsening the matter [1, 2] .

COVID-19 can be compounded by PH, wherein perioperative physician needs to modulate the anesthetic-analgesic-ventilation strategies minimizing any deterioration in the pulmonary dynamics, to ensure favorable outcome.

Cardiovascular considerations for anesthesiologists during the COVID-19 pandemic

Pulmonary hypertension and right ventricular involvement in hospitalised patients with COVID-19

A survey-based estimate of COVID-19 incidence and outcomes among patients with PAH or CTEPH and impact on the process of care

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Funding None.

The authors declared that they have no conflicts of interest.