TY - JOUR T1 - Pulmonary Hypertension: The Hallmark of Acute COVID-19 Microvascular Angiopathy? JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00389-2022 SP - 00389-2022 AU - Sri Harsha Dintakurti AU - Sanjana Kamath AU - Ciara Mahon AU - Suveer Singh AU - Bhavin Rawal AU - Simon P. G. Padley AU - Anand Devaraj AU - Laura C. Price AU - Sujal R. Desai AU - Tom Semple AU - Carole A. Ridge Y1 - 2023/01/01 UR - http://openres.ersjournals.com/content/early/2023/01/26/23120541.00389-2022.abstract N2 - There have been over 481 million cases of Coronavirus Disease-19 (COVID-19), caused by the SARS-CoV-2 virus worldwide since December 2019 [1]. One of the hallmark features of acute COVID-19 pneumonia is pulmonary vascular involvement, most commonly manifesting as pulmonary artery thrombosis (PAT) [2, 3]. Post-mortem data in ten patients with COVID-19 pneumonia shows their central pulmonary arteries were free of thrombosis but all patients had small, firm thrombi in the peripheral parenchyma [4]. These findings raise the possibility that the CT finding of isolated subsegmental PAT may reflect “the tip of the iceberg”; that small segmental thrombi may reflect downstream in situ thrombosis in the microvasculature. In patients with severe COVID-19 pneumonitis, Dual-Energy CTPA (DECTPA) has been used to demonstrate reduced pulmonary perfusion in the absence of any visible central thromboembolism [5, 6], further supporting the view that microscopic PAT is prevalent [6].FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: The authors have nothing to disclose.Conflict of interest: Laura Price has received support from Janssen Pharmaceuticals and Ferrer Pharmaceuticals to attend meetings outside the submitted work. Participation on a Data Safety Monitoring Board or Advisory Board for Janssen, outside the submitted work.Conflict of interest: The remaining authors have nothing to disclose. ER -