Th162 - Pulmonary Hypertension in a Cystic Fibrosis Child Following COVID 19: Case Report

Karine Simonyan – Chairman, Department of Pediatrics #1, Yerevan State Medical University, Muratsan University Hospital; Hasmik Yeghiazaryan – pediatric cardiologist, Department of Radiology, Yerevan State Medical University, Muratsan University Hospital

Abstract Text:

Background: COVID 19 pandemic was a disaster for the Globe. Cystic fibrosis (CF) also has been identified as a possible risk factor for poor outcome and long term consequences. Besides, overlaps between CF exacerbations and COVID 19 were associated with diagnostic dilemmas.

Case description: we report a case of a 12 year old CF girl (CFTRdele2/I175V), chronically infected with pseudomonas aeruginosa, who developed pulmonary hypertension following COVID 19 infection. Patient was admitted to the University ‘’Muratsan’’ hospital in December 2020 with shortness of breath, 3 day fever, increased cough with greenish phlegm, low oxygen saturation , decreased appetite and myalgia. PCR for SARS COVID 19 was positive, labs showed significantly high CRP, ESR and leucocytosis. Meropenem and amikacin, steroid pulse therapy were initiated. Besides disease specific changes ground glass opacities are found on CT. She was discharged at 16 day with clinical, laboratory and radiological improvement on home oxygen therapy, inhaled antibiotic and protocol based treatment. Patient was readmitted 2 weeks later with severe respiratory distress, low oxygen saturation, sleep disturbances. She was tested negative for respiratory viruses, laboratory tests and X-ray didn't found remarkable cause for deterioration: CRP was 18 mg/l, she cultured negative for Pseudomonas aeruginosa, atypical mycobacteria. Echocardiography detected significant pulmonary hypertension. Bosentan and sildenafil were added.

Conclusion: Pulmonary arterial hypertension should be suspected in a CF patient presenting after COVID 19 with worsened respiratory status, unexplained desaturation, night sleep disturbances.

Discussion: The prevention of COVID 19 in CF cohort should be prioritized.