COVID-19 in Adults With Congenital Heart Disease.

Broberg, Craig S; Kovacs, Adrienne H; Sadeghi, Soraya; Rosenbaum, Marlon S; Lewis, Matthew J; Carazo, Matthew R; Rodriguez, Fred H; Halpern, Dan G; Feinberg, Jodi; Galilea, Francisca Arancibia; Baraona, Fernando; Cedars, Ari M; Ko, Jong M; Porayette, Prashob; Maldonado, Jennifer; Sarubbi, Berardo; Fusco, Flavia; Frogoudaki, Alexandra A; Nir, Amiram; Chaudhry, Anisa; ... (2021). COVID-19 in Adults With Congenital Heart Disease. Journal of the American College of Cardiology, 77(13), pp. 1644-1655. Elsevier 10.1016/j.jacc.2021.02.023

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BACKGROUND

Adults with congenital heart disease (CHD) have been considered potentially high risk for novel coronavirus disease-19 (COVID-19) mortality or other complications.

OBJECTIVES

This study sought to define the impact of COVID-19 in adults with CHD and to identify risk factors associated with adverse outcomes.

METHODS

Adults (age 18 years or older) with CHD and with confirmed or clinically suspected COVID-19 were included from CHD centers worldwide. Data collection included anatomic diagnosis and subsequent interventions, comorbidities, medications, echocardiographic findings, presenting symptoms, course of illness, and outcomes. Predictors of death or severe infection were determined.

RESULTS

From 58 adult CHD centers, the study included 1,044 infected patients (age: 35.1 ± 13.0 years; range 18 to 86 years; 51% women), 87% of whom had laboratory-confirmed coronavirus infection. The cohort included 118 (11%) patients with single ventricle and/or Fontan physiology, 87 (8%) patients with cyanosis, and 73 (7%) patients with pulmonary hypertension. There were 24 COVID-related deaths (case/fatality: 2.3%; 95% confidence interval: 1.4% to 3.2%). Factors associated with death included male sex, diabetes, cyanosis, pulmonary hypertension, renal insufficiency, and previous hospital admission for heart failure. Worse physiological stage was associated with mortality (p = 0.001), whereas anatomic complexity or defect group were not.

CONCLUSIONS

COVID-19 mortality in adults with CHD is commensurate with the general population. The most vulnerable patients are those with worse physiological stage, such as cyanosis and pulmonary hypertension, whereas anatomic complexity does not appear to predict infection severity.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Ruperti Repilado, Francisco Javier and Schwerzmann, Markus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0735-1097

Publisher:

Elsevier

Language:

English

Submitter:

Markus Schwerzmann

Date Deposited:

08 Feb 2022 16:06

Last Modified:

08 Feb 2022 16:06

Publisher DOI:

10.1016/j.jacc.2021.02.023

PubMed ID:

33795039

Uncontrolled Keywords:

COVID-19 adult congenital heart disease coronavirus hospitalization

BORIS DOI:

10.48350/164740

URI:

https://boris.unibe.ch/id/eprint/164740

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