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COVID-19 in congenital heart disease (COaCHeD) study
Sian Chivers1,2, Aoife Cleary2,3, Rachel Knowles4,5
1Department of Congenital Cardiology, Royal Brompton & Harefield NHS Foundation Trust, London, UK.
Open Heart
|July 17, 2023
Summary
COVID-19 posed a low mortality risk for children with congenital heart disease (CHD). However, adult patients with CHD faced increased risks of death and hospitalization, particularly with advanced age, comorbidities, and pulmonary arterial hypertension.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- COVID-19 has caused significant global morbidity and mortality.
- Congenital heart disease (CHD) may increase vulnerability to severe COVID-19 outcomes.
- Understanding predictors of adverse outcomes in CHD patients is crucial for optimizing care during the pandemic.
Purpose of the Study:
- To ascertain the impact of COVID-19 on individuals with CHD.
- To define risk factors associated with adverse outcomes in CHD patients following COVID-19 infection.
Main Methods:
- A multicentre UK study was conducted from March 2020 to June 2021.
- Data on CHD diagnoses, clinical presentation, and outcomes were collected.
- Multivariable logistic regression with multiple imputation was used to identify predictors of death and hospitalization.
Main Results:
- The study included 405 cases (127 pediatric, 278 adult). Pediatric deaths were 3.9%, with lower hospitalization rates in older children.
- Adult deaths were 8.6% (19 with comorbidities), and 26.6% were hospitalized.
- Increased age and pulmonary arterial hypertension (PAH) predicted death in adults. Age, comorbidities, and genetic disease predicted hospitalization in adults.
Conclusions:
- Children with CHD, even severe cases, had a low risk of death and hospitalization from COVID-19.
- Adults with CHD faced higher mortality risks with increasing age and PAH, and higher hospitalization risks with age, comorbidities, and genetic disease.
- An individualized approach to COVID-19 management for CHD patients, considering age and comorbidities, is recommended.
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