TY - JOUR
T1 - COVID-19 in Adults With Congenital Heart Disease
AU - Broberg, Craig S.
AU - Kovacs, Adrienne H.
AU - Sadeghi, Soraya
AU - Rosenbaum, Marlon S.
AU - Lewis, Matthew J.
AU - Carazo, Matthew R.
AU - Rodriguez, Fred H.
AU - Halpern, Dan G.
AU - Feinberg, Jodi
AU - Galilea, Francisca Arancibia
AU - Baraona, Fernando
AU - Cedars, Ari M.
AU - Ko, Jong M.
AU - Porayette, Prashob
AU - Maldonado, Jennifer
AU - Sarubbi, Berardo
AU - Fusco, Flavia
AU - Frogoudaki, Alexandra A.
AU - Nir, Amiram
AU - Chaudhry, Anisa
AU - John, Anitha S.
AU - Karbassi, Arsha
AU - Hoskoppal, Arvind K.
AU - Frischhertz, Benjamin P.
AU - Hendrickson, Benjamin
AU - Bouma, Berto J.
AU - Rodriguez-Monserrate, Carla P.
AU - Broda, Christopher R.
AU - Tobler, Daniel
AU - Gregg, David
AU - Martinez-Quintana, Efren
AU - Yeung, Elizabeth
AU - Krieger, Eric V.
AU - Ruperti-Repilado, Francisco J.
AU - Giannakoulas, George
AU - Lui, George K.
AU - Ephrem, Georges
AU - Singh, Harsimran S.
AU - Almeneisi, Hassan MK
AU - Bartlett, Heather L.
AU - Lindsay, Ian
AU - Grewal, Jasmine
AU - Nicolarsen, Jeremy
AU - Araujo, John J.
AU - Cramer, Jonathan W.
AU - Bouchardy, Judith
AU - Al Najashi, Khalid
AU - Ryan, Kristi
AU - Alshawabkeh, Laith
AU - Andrade, Lauren
AU - Ladouceur, Magalie
AU - Schwerzmann, Markus
AU - Greutmann, Matthias
AU - Meras, Pablo
AU - Ferrero, Paolo
AU - Dehghani, Payam
AU - Tung, Poyee P.
AU - Garcia-Orta, Rocio
AU - Tompkins, Rose O.
AU - Gendi, Salwa M.
AU - Cohen, Scott
AU - Klewer, Scott
AU - Hascoet, Sebastien
AU - Mohammadzadeh, Shabnam
AU - Upadhyay, Shailendra
AU - Fisher, Stacy D.
AU - Cook, Stephen
AU - Cotts, Timothy B.
AU - Aboulhosn, Jamil A.
N1 - Funding Information:
The authors are grateful for the statistical input of Jessica Minnier, assistant professor of biostatistics in the School of Public Health and Knight Cardiovascular Institute, Oregon Health and Science University.
Publisher Copyright:
© 2021 American College of Cardiology Foundation
PY - 2021/4/6
Y1 - 2021/4/6
N2 - 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.
AB - 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.
KW - COVID-19
KW - adult congenital heart disease
KW - coronavirus
KW - hospitalization
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U2 - 10.1016/j.jacc.2021.02.023
DO - 10.1016/j.jacc.2021.02.023
M3 - Article
C2 - 33795039
AN - SCOPUS:85103044315
VL - 77
SP - 1644
EP - 1655
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 13
ER -