Outcomes of COVID-19 infection in pediatric pulmonary hypertension: A single-center experience.

Background The global COVID-19 pandemic was particularly concerning for the pediatric PH population due to immature immune systems and developmental comorbidities. This study aims to describe a single-center experience of pediatric PH patients diagnosed with COVID-19 disease. Methods Retrospective cohort study of all pediatric patients followed by the PH Center at Texas Children's Hospital diagnosed with COVID-19 infection from 04/2020 through 02/2021. Results We identified 23 patients with a median age of 58 months (IQR 25-75th, 21-132 months), 48% being Hispanics. Eight patients (35%) required hospitalization; median length of stay 6 days (IQR 25-75th , 5-8 days). Only three of these 8 patients required increased respiratory support. Targeted PH therapy was escalated in four patients (two in dual and two in triple therapy). There was one mortality in a patient with failing Fontan physiology. Ninety-one percent of patients have had post-COVID outpatient follow-up, median of 101 days (IQR 25-75th , 50-159 days) from diagnosis. Of the five patients with 6 minute walk test (6MWT) data, three (60%) children walked less distance, median -12 meters (IQR 25-75th , -12 - +49 meters) compared to pre-COVID testing. Post-infection pulmonary function testing (PFT) was notable for decrease in predicted forced vital capacity (FVC) (median -6%, range -11%-+6%) and forced expiratory volume in one second (FEV1) (median -14%, range -12- -18%) in 75% of the patients with PFT data. Conclusions In our institution, COVID-19 was found more frequently in Hispanics, and associated with low mortality. This article is protected by copyright. All rights reserved.