Impact of COVID-19 infection on patients with congenital heart disease


Date:
October 14, 2020
Source:
American Heart Association
Summary:
Results of a retrospective analysis suggest that people born with
a heart defect who developed COVID-19 symptoms had a low risk of
moderate or severe COVID-19 infection, according to a new article.



FULL STORY ========================================================================== Results of a retrospective analysis suggest that people born with a
heart defect who developed COVID-19 symptoms had a low risk of moderate
or severe COVID-19 infection, according to a new article published today
in the Journal of the American Heart Association, an open access journal
of the American Heart Association.


==========================================================================
In what may be the largest study of its kind to date, researchers at
Columbia University Vagelos College of Physicians and Surgeons in New
York City explored the impact of COVID-19 infection on patients with
congenital heart disease (CHD). The specialty center follows more than
7,000 adult and pediatric patients born with a heart defect. Fifty-three
CHD patients (median age 34) with COVID-19 infection were reported at
their center between March and July 2020.

"At the beginning of the pandemic, many feared that congenital heart
disease would be as big a risk factor for COVID-19 as adult-onset cardiovascular disease" the researchers wrote. However, they are
"reassured by the low number of patients treated at their center
and the patients' outcomes." Among the 43 adults and 10 children
with a congenital heart defect infected with COVID-19 , additional characteristics included: 58% had complex congenital anatomy; 15%
had a genetic syndrome; 11% had pulmonary hypertension; and 17% had
obesity. Additional analysis found:
* The presence of a concurrent genetic syndrome in all patients and
advanced physiologic stage in adult patients were each associated
with an increased risk of symptom severity.

* Five patients had trisomy 21 (an extra chromosome at position
21); four
patients had Eisenmenger's syndrome (abnormal blood circulation
caused by structural defects in the heart); and two patients had
DiGeorge syndrome (a condition caused by the deletion of a segment
of chromosome 22).

Nearly all patients with trisomy 21 and DiGeorge syndrome had
moderate/ severe COVID-19 symptoms.

* As for outcomes among all 53 patients with CHD: nine patients
(17%) had a
moderate/severe infection, and three patients (6%) died.

In addition, the researchers note several limitations to their analysis:
* "While our sample size is small, these results imply that specific
congenital heart lesions may not be sufficient cause alone for
severe COVID-19 infection."
* "While it is possible that our patient population exercised stricter
adherence to social distancing given early publicized concerns
about cardiac risk, these early results appear reassuring."
* ." ..the median age and the frequency of acquired cardiac risk
factors
were lower in hospitalized patients in our cohort compared to
published reports of hospitalized patients from COVID-19 in NYC at
large. This may be because the CHD community, at large, is younger
than the general population or because individuals with CHD may
have distinct risk factors for severe COVID-19 infection when
compared to the general population. It is possible that a cohort
of elderly CHD patients might have a different risk profile than
the general population."
The researchers concluded, "Despite evidence that adult-onset
cardiovascular disease is a risk factor for worse outcomes among patients
with COVID-19, patients with CHD without concomitant genetic syndrome,
and adults who are not at advanced physiological stage, do not appear
to be disproportionately impacted."

========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Matthew J Lewis, Brett R Anderson, Michael Fremed, Melissa Argenio,
Usha
Krishnan, Rachel Weller, Ste'phanie Levasseur, Robert Sommer, Irene
D Lytrivi, Emile A. Bacha, Julie Vincent, Wendy K Chung, Erika B.

Rosenzweig, Thomas J Starc, Marlon Rosenbaum. The Impact of
Coronavirus disease 2019 (COVID‐19) on Patients with
Congenital Heart Disease across the Lifespan: The Experience
of an Academic Congenital Heart Disease Center in New York
City. Journal of the American Heart Association, 2020; DOI:
10.1161/JAHA.120.017580 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/10/201014141030.htm

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