Pulmonary embolism (PE) is a well-recognised complication of coronavirus disease 2019 (COVID-19) infection, and chronic thromboembolic pulmonary disease with and without pulmonary hypertension (CTEPD/CTEPH) are potential life-limiting consequences. At present the burden of CTEPD/CTEPH is unclear and optimal and cost-effective screening strategies yet to be established.

We evaluated the CTEPD/CTEPH referral rate to the UK national multidisciplinary team (MDT) during the 2017–2022 period to establish the national incidence of CTEPD/CTEPH potentially attributable to COVID-19-associated PE with historical comparator years. All individual cases of suspected CTEPH were reviewed by the MDT for evidence of associated COVID-19. In a separate multicentre cohort, the risk of developing CTEPH following hospitalisation with COVID-19 was calculated using simple clinical parameters at a median of 5 months post-hospital discharge according to existing risk scores using symptoms, ECG and N-terminal pro-brain natriuretic peptide.

By the second year of the pandemic, CTEPH diagnoses had returned to the pre-pandemic baseline (23.1 versus 27.8 cases per month; p=0.252). Of 334 confirmed CTEPD/CTEPH cases, four (1.2%) patients were identified to have CTEPH potentially associated with COVID-19 PE, and a further three (0.9%) CTEPD without PH. Of 1094 patients (mean age 58 years, 60.4% male) hospitalised with COVID-19 screened across the UK, 11 (1.0%) were at high risk of CTEPH at follow-up, none of whom had a diagnosis of CTEPH made at the national MDT.

A priori risk of developing CTEPH following COVID-19-related hospitalisation is low. Simple risk scoring is a potentially effective way of screening patients for further investigation.

肺栓塞 （PE） 是 2019 冠状病毒病 （COVID-19） 感染的一种公认的并发症，伴有和不伴有肺动脉高压的慢性血栓栓塞性肺病 （CTEPD/CTEPH） 是潜在的限制生命的后果。目前，CTEPD/CTEPH 的负担尚不清楚，最佳且具有成本效益的筛查策略尚未建立。

我们评估了 2017-2022 年期间英国国家多学科团队 （MDT） 的 CTEPD/CTEPH 转诊率，以确定可能归因于 COVID-19 相关 PE 的 CTEPD/CTEPH 的全国发病率与历史比较年份。MDT 审查了所有疑似 CTEPH 的个体病例，以寻找相关 COVID-19 的证据。在一个单独的多中心队列中，根据现有风险评分，使用症状、心电图和 N 末端脑利钠肽，使用简单的临床参数计算出院后 COVID-19 住院后发生 CTEPH 的风险，中位数为 5 个月。

到大流行的第二年，CTEPH 诊断已恢复到大流行前的基线水平（每月 23.1 例对 27.8 例;p=0.252）。在 334 例确诊的 CTEPD/CTEPH 病例中，4 例 （1.2%） 患者被确定患有可能与 COVID-19 PE 相关的 CTEPH，另外 3 例 （0.9%） CTEPD 无 PH。在英国筛查的 1094 名因 COVID-19 住院的患者 （平均年龄 58 岁，60.4% 为男性） 中，11 名 （1.0%） 在随访时处于 CTEPH 的高风险中，没有人在国家 MDT 中被诊断为 CTEPH。

COVID-19 相关住院后发生 CTEPH 的先验风险较低。简单风险评分是筛查患者以进行进一步调查的一种潜在有效方法。