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COVID-19 and congenital heart disease: an insight of pathophysiology and associated risks
Ana Alina Haiduc1, Michael Ogunjimi2, Rohma Shammus1
1Medical School, St George's, University of London, Cranmer Terrace, UK.
Insights
Congenital heart disease (CHD) patients with coronavirus disease 2019 (COVID-19) may face increased risks of adverse outcomes. Further research with larger cohorts is needed to confirm these findings for COVID-19 and CHD patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Congenital heart disease (CHD) affects individuals across all age groups.
- The impact of coronavirus disease 2019 (COVID-19) on patients with CHD is not fully understood.
- Existing literature includes case reports and series, necessitating a comprehensive review.
Purpose of the Study:
- To systematically review existing literature on the risk of poor outcomes in pediatric and adult patients with CHD who contract COVID-19.
- To compare outcomes of COVID-19 in patients with and without CHD.
- To identify potential increased risks associated with co-infection.
Main Methods:
- A systematic literature review adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.
- Extensive database searches on EMBASE, Medline, Scopus, and Global Health.
- Keyword and Medical Subject Headings (MeSH) term utilization for article identification.
Main Results:
- Twelve articles met the inclusion criteria for the systematic review.
- Data analysis focused on themes of increased risk and no increased risk in CHD patients.
- Out of 99 CHD patients analyzed, 12 required intensive care unit (ICU) admission.
Conclusions:
- Congenital heart disease may be associated with an elevated risk of adverse outcomes in patients with COVID-19.
- The current evidence base, primarily from case studies, necessitates more robust research.
- Future studies should aim for larger sample sizes and control for confounding factors to quantify risk accurately.
Objective:
We aimed to examine the literature to determine if both paediatric and adult patients diagnosed with congenital heart disease (CHD) are at a higher risk of poor outcomes if they have the coronavirus disease 2019 (COVID-19), compared to those without CHD.
Methods:
A systematic review was executed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. To identify articles related to COVID-19 and CHD, an extensive literature search was performed on EMBASE, Medline, Scopus, and Global Health databases using keywords and MeSH terms.
Results:
A total of 12 articles met the inclusion criteria and were included for analysis in this systematic review. Two themes were identified for data extraction: evidence supporting higher risks in CHD patients and evidence against higher risks in CHD patients. After combining the data, there were 99 patients with CHDs out of which 12 required admissions to ICU.
Conclusion:
This systematic review suggests that CHD may increase the risk of poor outcomes for those with COVID-19, but also highlights the necessity for more research with larger sample sizes in order to make a more justified conclusion, as the majority of papers that were analysed were case series and case reports. Future research should aim to quantify the risks if possible whilst accounting for various confounding factors such as age and treatment history.
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