COVID-19 in adults with congenital heart disease: early morbidity and mortality in two northern Italian specialist centers

Abstract

There is no information on coronavirus disease 2019 (COVID-19)-related outcomes for adult patients with congenital heart disease (ACHD). We aim to assess the clinical burden of COVID-19 on ACHD patients during the initial stages of the pandemic in Europe. ACHD patients followed in 2 tertiary centers in the Lombardy region were screened for COVID-19-related symptoms and complications. 661 patients (52.3% male, mean age 34.9±11.7 years) with CHD of moderate (58.5%) or high (32.8%) complexity were contacted. Of these, 145 (21.9%) reported typical COVID-19 symptoms, but only 4.8% required hospitalization. We did not record confirmed COVID-19-related deaths. Patients hospitalized were elderly (P=0.03), more likely to be receiving diuretics (P=0.03) or beta-blockers (P=0.02), and have been admitted over the previous year (P=0.003). Of the 7 patients hospitalized, 2 had a systemic RV and 2 a Fontan circulation. COVID-19-related morbidity and mortality have been low in ACHD patients 6 weeks from the start of the outbreak, in one of the worse hit European regions.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020 [Epub ahead of print]. DOI: https://doi.org/10.1001/jama.2020.5394

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5

Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic. J Am Coll Cardiol 2020. [Epub ahead of print]. DOI: https://doi.org/10.1016/j.jacc.2020.03.031

Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;0. [Epub ahead of print].

Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC Guideline for the management of adults with congenital heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019;73:1494-563. DOI: https://doi.org/10.1016/j.jacc.2018.08.1028

Tan W, Aboulhosn J. The cardiovascular burden of coronavirus disease 2019 (COVID-19) with a focus on congenital heart disease. Int J Cardiol 2020 [Epub ahead of print]. DOI: https://doi.org/10.1016/j.ijcard.2020.03.063

Elkind MSV, Harrington RA, Benjamin IJ. The role of the American Heart Association in the global COVID-19 pandemic. Circulation 2020;141:e743-5. DOI: https://doi.org/10.1161/CIRCULATIONAHA.120.046749

Skulstad H, Cosyns B, Popescu BA, et al. COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. Eur Heart J Cardiovasc Imaging 2020 [Epub ahead of print]. DOI: https://doi.org/10.1093/ehjci/jeaa072

Lakkireddy DR, Chung MK, Gopinathannair R, et al. Guidance for cardiac electrophysiology during the coronavirus (COVID-19) pandemic from the Heart Rhythm Society COVID-19 task force; Electrophysiology section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association. Circulation 2020 [Epub ahead of print]. DOI: https://doi.org/10.1016/j.hrthm.2020.03.028

Warnes CA, Liberthson R, Danielson GK, et al. Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 2001;37:1170-5. DOI: https://doi.org/10.1016/S0735-1097(01)01272-4

Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging 2020;12. [Epub ahead of print]. DOI: https://doi.org/10.18632/aging.103000

Organization WH. Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19): interim guidance, 19 March 2020. [Epub ahead of print].

Beeching NJ, Fletcher TE, Beadsworth MBJ. Covid-19: testing times. BMJ 2020;369:m1403. DOI: https://doi.org/10.1136/bmj.m1403

Tutarel O, Alonso-Gonzalez R, Montanaro C, et al. Infective endocarditis in adults with congenital heart disease remains a lethal disease. Heart Br Card Soc 2018;104:161-5. DOI: https://doi.org/10.1136/heartjnl-2017-311650

Constantine A, Barradas-Pires A, Dimopoulos K. Modifiable risk factors in congenital heart disease: Education, transition, digital health and choice architecture. Eur J Prev Cardiol 2019:2047487319874146. DOI: https://doi.org/10.1177/2047487319874146

Wang K, Gheblawi M, Oudit GY. Angiotensin converting enzyme 2: a double-edged sword. Circulation 2020 [Epub ahead of print]. DOI: https://doi.org/10.1161/CIRCULATIONAHA.120.047049

Yang H, Bouma BJ, Dimopoulos K, et al. Non-vitamin K antagonist oral anticoagulants (NOACs) for thromboembolic prevention, are they safe in congenital heart disease? Results of a worldwide study. Int J Cardiol 2020;299:123-30. DOI: https://doi.org/10.1016/j.ijcard.2019.06.014

Matchar DB, Jacobson A, Dolor R, et al. Effect of home testing of international normalized ratio on clinical events. N Engl J Med 2010;363:1608-20. DOI: https://doi.org/10.1056/NEJMoa1002617

Published
2021-03-18
Info
Issue
Section
Original Articles
Keywords:
Adult congenital heart disease, COVID-19, survey.
Statistics
  • Abstract views: 57

  • PDF: 57
  • HTML: 0
How to Cite
Ferrero, P., Chessa, M., Piazza, I., Bonino, C., Ferrari, I., Giamberti, A., Ciuffreda, M., & Dimopoulos, K. (2021). COVID-19 in adults with congenital heart disease: early morbidity and mortality in two northern Italian specialist centers. Italian Journal of Medicine, 15(1). https://doi.org/10.4081/itjm.2021.1397