Journal article
COVID-19 in Adults With Congenital Heart Disease
Journal of the American College of Cardiology, Vol.77(13), pp.1644-1655
04/06/2021
DOI: 10.1016/j.jacc.2021.02.023
PMCID: PMC8006800
PMID: 33795039
Abstract
Adults with congenital heart disease (CHD) have been considered potentially high risk for novel coronavirus disease-19 (COVID-19) mortality or other complications.
This study sought to define the impact of COVID-19 in adults with CHD and to identify risk factors associated with adverse outcomes.
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.
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.
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.
Details
- Title: Subtitle
- COVID-19 in Adults With Congenital Heart Disease
- Creators
- Craig S Broberg - Oregon Health & Science UniversityAdrienne H Kovacs - Oregon Health & Science UniversitySoraya Sadeghi - University of California, Los AngelesMarlon S Rosenbaum - Columbia UniversityMatthew J Lewis - Columbia UniversityMatthew R Carazo - Emory UniversityFred H Rodriguez III - Emory University School of MedicineDan G Halpern - New York UniversityJodi Feinberg - New York UniversityFrancisca Arancibia Galilea - Pontificia Universidad Católica de ChileFernando Baraona - Pontificia Universidad Católica de ChileAri M Cedars - Johns Hopkins UniversityJong M Ko - Johns Hopkins UniversityPrashob Porayette - University of IowaJennifer Maldonado - University of IowaBerardo Sarubbi - Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, ItalyFlavia Fusco - Monaldi Hospital, Adult Congenital Heart Disease Unit, Naples, ItalyAlexandra A Frogoudaki - National and Kapodistrian University of AthensAmiram Nir - Shaare Zedek Medical CenterAnisa Chaudhry - Pennsylvania State UniversityAnitha S John - Children's NationalArsha Karbassi - McMaster UniversityArvind K Hoskoppal - University of PittsburghBenjamin P Frischhertz - Vanderbilt UniversityBenjamin Hendrickson - University of Tennessee Health Science CenterBerto J Bouma - University of AmsterdamCarla P Rodriguez-Monserrate - Harvard UniversityChristopher R Broda - Baylor College of MedicineDaniel Tobler - University of BaselDavid Gregg - Medical University of South CarolinaEfren Martinez-Quintana - Cardiology Service, Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, SpainElizabeth Yeung - University of Colorado Anschutz Medical CampusEric V Krieger - University of WashingtonFrancisco J Ruperti-Repilado - University of GenevaGeorge Giannakoulas - Aristotle University of ThessalonikiGeorge K Lui - Stanford UniversityGeorges Ephrem - Indiana UniversityHarsimran S Singh - NewYork–Presbyterian HospitalHassan Mk Almeneisi - Cincinnati Children's Hospital Medical CenterHeather L Bartlett - University of Wisconsin–MadisonIan Lindsay - University of UtahJasmine Grewal - University of British ColumbiaJeremy NicolarsenJohn J Araujo - Department of Pediatric and Adult Congenital Heart Disease, Somer Incare Cardiovascular Center, Rionegro, ColombiaJonathan W Cramer - University of Nebraska Medical CenterJudith Bouchardy - University of LausanneKhalid Al Najashi - Pediatric Cardiology Department, Prince Sultan Cardiac Center, Riyadh, Saudi ArabiaKristi Ryan - Boston Children's HospitalLaith Alshawabkeh - University of California San DiegoLauren Andrade - University of PennsylvaniaMagalie Ladouceur - Hôpital Européen Georges-PompidouMarkus Schwerzmann - University of BernMatthias Greutmann - University of ZurichPablo Meras - Universidad Autónoma de MadridPaolo Ferrero - University of MilanPayam Dehghani - University of SaskatchewanPoyee P Tung - The University of Texas Health Science Center at HoustonRocio Garcia-Orta - Hospital Universitario Virgen de las NievesRose O Tompkins - Cedars-Sinai Medical CenterSalwa M Gendi - West Virginia UniversityScott Cohen - Medical College of WisconsinScott Klewer - University of ArizonaSebastien Hascoet - Hôpital Marie LannelongueShabnam Mohammadzadeh - Tehran University of Medical SciencesShailendra Upadhyay - Connecticut Children's Medical CenterStacy D Fisher - University of Maryland, BaltimoreStephen Cook - Spectrum HealthTimothy B Cotts - University of MichiganJamil A Aboulhosn - University of California, Los Angeles
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Cardiology, Vol.77(13), pp.1644-1655
- DOI
- 10.1016/j.jacc.2021.02.023
- PMID
- 33795039
- PMCID
- PMC8006800
- NLM abbreviation
- J Am Coll Cardiol
- ISSN
- 0735-1097
- eISSN
- 1558-3597
- Language
- English
- Date published
- 04/06/2021
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics; Internal Medicine
- Record Identifier
- 9984354051702771
Metrics
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