Pulmonary vascular disease in patients with Long COVID

Our goal is to determine the role of pulmonary vascular disease as a cause for persistent breathlessness (dyspnea) in patients with "Long COVID". Pulmonary Vascular Involvement in COVID-19 Inflammation, clotting (thrombosis), and damage to the pulmonary blood vessels has been demonstrated in patients acutely ill with COVID-19. Many patients who have "recovered" from COVID-19 continue to experience symptoms. Over half of patients report persistent dyspnea or fatigue at two months after hospital discharge, which has been characterized as "Long-COVID". Long-COVID patients often have normal breathing tests and most have normal chest x-ray findings. Pulmonary vascular disease is a possible cause of dyspnea in patients with normal pulmonary function, which is often difficult to detect. Exercise Hemodynamics Can Detect Pulmonary Vascular Disease Since the blood vessels in the lungs can be damaged during acute COVID-19 infection, we need to test ways to detect long-term pulmonary vascular disease. Pulmonary vascular disease often goes undetected with measures of resting lung and heart function. However, pulmonary vascular disease can be detected with exercise testing during right heart catheterization. Research Aims In Aim 1 we will the feasibility of a testing strategy for pulmonary vascular disease in patients with Long Covid across 3 Canadian centres. We will determine if it's possible to use a battery of tests including exercise right heart catheterization, imaging, and blood tests that can possibly detect early disease. In Aim 2 we will test whether patients with Long COVID have features of pulmonary vascular disease based on their exercise testing, imaging and blood tests. This study may establish whether some patients with Long COVID have pulmonary vascular disease. This project is necessary to inform future research so that we can better understand how common this condition is and whether it can be treated with drugs that are already available.