COVID-19 in Adults With Congenital Heart Disease

Craig S. Broberg; Adrienne H. Kovacs; Soraya Sadeghi; Marlon S. Rosenbaum; Matthew J. Lewis; Matthew R. Carazo; Fred H. Rodriguez; Dan G. Halpern; Jodi Feinberg; Francisca Arancibia Galilea; Fernando Baraona; Ari M. Cedars; Jong M. Ko; Prashob Porayette; Jennifer Maldonado; Berardo Sarubbi; Flavia Fusco; Alexandra A. Frogoudaki; Amiram Nir; Anisa Chaudhry; Anitha S. John; Arsha Karbassi; Arvind K. Hoskoppal; Benjamin P. Frischhertz; Benjamin Hendrickson; Berto J. Bouma; Carla P. Rodriguez-Monserrate; Christopher R. Broda; Daniel Tobler; David Gregg; Efren Martinez-Quintana; Elizabeth Yeung; Eric V. Krieger; Francisco J. Ruperti-Repilado; George Giannakoulas; George K. Lui; Georges Ephrem; Harsimran S. Singh; Hassan MK Almeneisi; Heather L. Bartlett; Ian Lindsay; Jasmine Grewal; Jeremy Nicolarsen; John J. Araujo; Jonathan W. Cramer; Judith Bouchardy; Khalid Al Najashi; Kristi Ryan; Laith Alshawabkeh; Lauren Andrade; Magalie Ladouceur; Markus Schwerzmann; Matthias Greutmann; Pablo Meras; Paolo Ferrero; Payam Dehghani; Poyee P. Tung; Rocio Garcia-Orta; Rose O. Tompkins; Salwa M. Gendi; Scott Cohen; Scott Klewer; Sebastien Hascoet; Shabnam Mohammadzadeh; Shailendra Upadhyay; Stacy D. Fisher; Stephen Cook; Timothy B. Cotts; Jamil A. Aboulhosn

doi:10.1016/j.jacc.2021.02.023

COVID-19 in Adults With Congenital Heart Disease

Craig S. Broberg, Adrienne H. Kovacs, Soraya Sadeghi, Marlon S. Rosenbaum, Matthew J. Lewis, Matthew R. Carazo, Fred H. Rodriguez, Dan G. Halpern, Jodi Feinberg, Francisca Arancibia Galilea, Fernando Baraona, Ari M. Cedars, Jong M. Ko, Prashob Porayette, Jennifer Maldonado, Berardo Sarubbi, Flavia Fusco, Alexandra A. Frogoudaki, Amiram Nir, Anisa ChaudhryAnitha S. John, Arsha Karbassi, Arvind K. Hoskoppal, Benjamin P. Frischhertz, Benjamin Hendrickson, Berto J. Bouma, Carla P. Rodriguez-Monserrate, Christopher R. Broda, Daniel Tobler, David Gregg, Efren Martinez-Quintana, Elizabeth Yeung, Eric V. Krieger, Francisco J. Ruperti-Repilado, George Giannakoulas, George K. Lui, Georges Ephrem, Harsimran S. Singh, Hassan MK Almeneisi, Heather L. Bartlett, Ian Lindsay, Jasmine Grewal, Jeremy Nicolarsen, John J. Araujo, Jonathan W. Cramer, Judith Bouchardy, Khalid Al Najashi, Kristi Ryan, Laith Alshawabkeh, Lauren Andrade, Magalie Ladouceur, Markus Schwerzmann, Matthias Greutmann, Pablo Meras, Paolo Ferrero, Payam Dehghani, Poyee P. Tung, Rocio Garcia-Orta, Rose O. Tompkins, Salwa M. Gendi, Scott Cohen, Scott Klewer, Sebastien Hascoet, Shabnam Mohammadzadeh, Shailendra Upadhyay, Stacy D. Fisher, Stephen Cook, Timothy B. Cotts, Jamil A. Aboulhosn

Department of Medicine

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	1644-1655
Number of pages	12
Journal	Journal of the American College of Cardiology
Volume	77
Issue number	13
DOIs	https://doi.org/10.1016/j.jacc.2021.02.023
State	Published - Apr 6 2021

Keywords

COVID-19
adult congenital heart disease
coronavirus
hospitalization

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.jacc.2021.02.023

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Broberg, C. S., Kovacs, A. H., Sadeghi, S., Rosenbaum, M. S., Lewis, M. J., Carazo, M. R., Rodriguez, F. H., Halpern, D. G., Feinberg, J., Galilea, F. A., Baraona, F., Cedars, A. M., Ko, J. M., Porayette, P., Maldonado, J., Sarubbi, B., Fusco, F., Frogoudaki, A. A., Nir, A., ... Aboulhosn, J. A. (2021). COVID-19 in Adults With Congenital Heart Disease. Journal of the American College of Cardiology, 77(13), 1644-1655. https://doi.org/10.1016/j.jacc.2021.02.023

Broberg, CS, Kovacs, AH, Sadeghi, S, Rosenbaum, MS, Lewis, MJ, Carazo, MR, Rodriguez, FH, Halpern, DG, Feinberg, J, Galilea, FA, Baraona, F, Cedars, AM, Ko, JM, Porayette, P, Maldonado, J, Sarubbi, B, Fusco, F, Frogoudaki, AA, Nir, A, Chaudhry, A, John, AS, Karbassi, A, Hoskoppal, AK, Frischhertz, BP, Hendrickson, B, Bouma, BJ, Rodriguez-Monserrate, CP, Broda, CR, Tobler, D, Gregg, D, Martinez-Quintana, E, Yeung, E, Krieger, EV, Ruperti-Repilado, FJ, Giannakoulas, G, Lui, GK, Ephrem, G, Singh, HS, Almeneisi, HMK, Bartlett, HL, Lindsay, I, Grewal, J, Nicolarsen, J, Araujo, JJ, Cramer, JW, Bouchardy, J, Al Najashi, K, Ryan, K, Alshawabkeh, L, Andrade, L, Ladouceur, M, Schwerzmann, M, Greutmann, M, Meras, P, Ferrero, P, Dehghani, P, Tung, PP, Garcia-Orta, R, Tompkins, RO, Gendi, SM, Cohen, S, Klewer, S, Hascoet, S, Mohammadzadeh, S, Upadhyay, S, Fisher, SD, Cook, S, Cotts, TB & Aboulhosn, JA 2021, 'COVID-19 in Adults With Congenital Heart Disease', Journal of the American College of Cardiology, vol. 77, no. 13, pp. 1644-1655. https://doi.org/10.1016/j.jacc.2021.02.023

@article{247d711658b34b18aee88cd13dcf3f89,

title = "COVID-19 in Adults With Congenital Heart Disease",

abstract = "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.",

keywords = "COVID-19, adult congenital heart disease, coronavirus, hospitalization",

author = "Broberg, {Craig S.} and Kovacs, {Adrienne H.} and Soraya Sadeghi and Rosenbaum, {Marlon S.} and Lewis, {Matthew J.} and Carazo, {Matthew R.} and Rodriguez, {Fred H.} and Halpern, {Dan G.} and Jodi Feinberg and Galilea, {Francisca Arancibia} and Fernando Baraona and Cedars, {Ari M.} and Ko, {Jong M.} and Prashob Porayette and Jennifer Maldonado and Berardo Sarubbi and Flavia Fusco and Frogoudaki, {Alexandra A.} and Amiram Nir and Anisa Chaudhry and John, {Anitha S.} and Arsha Karbassi and Hoskoppal, {Arvind K.} and Frischhertz, {Benjamin P.} and Benjamin Hendrickson and Bouma, {Berto J.} and Rodriguez-Monserrate, {Carla P.} and Broda, {Christopher R.} and Daniel Tobler and David Gregg and Efren Martinez-Quintana and Elizabeth Yeung and Krieger, {Eric V.} and Ruperti-Repilado, {Francisco J.} and George Giannakoulas and Lui, {George K.} and Georges Ephrem and Singh, {Harsimran S.} and Almeneisi, {Hassan MK} and Bartlett, {Heather L.} and Ian Lindsay and Jasmine Grewal and Jeremy Nicolarsen and Araujo, {John J.} and Cramer, {Jonathan W.} and Judith Bouchardy and {Al Najashi}, Khalid and Kristi Ryan and Laith Alshawabkeh and Lauren Andrade and Magalie Ladouceur and Markus Schwerzmann and Matthias Greutmann and Pablo Meras and Paolo Ferrero and Payam Dehghani and Tung, {Poyee P.} and Rocio Garcia-Orta and Tompkins, {Rose O.} and Gendi, {Salwa M.} and Scott Cohen and Scott Klewer and Sebastien Hascoet and Shabnam Mohammadzadeh and Shailendra Upadhyay and Fisher, {Stacy D.} and Stephen Cook and Cotts, {Timothy B.} and Aboulhosn, {Jamil A.}",

note = "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: {\textcopyright} 2021 American College of Cardiology Foundation",

year = "2021",

month = apr,

day = "6",

doi = "10.1016/j.jacc.2021.02.023",

language = "English (US)",

volume = "77",

pages = "1644--1655",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier USA",

number = "13",

}

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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UR - http://www.scopus.com/inward/citedby.url?scp=85103044315&partnerID=8YFLogxK

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 -

COVID-19 in Adults With Congenital Heart Disease

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