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Low Risk of Moderate or Severe COVID-19 in Congenital Heart Disease

RETROSPECTIVE data analysed by researchers at Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA have shown that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in patients with congenital heart disease (CHD) was associated with a low risk of moderate or severe coronavirus disease (COVID-19) 

More than 7,000 adult and paediatric patients born with a heart defect were involved in the study, of which 53 patients presented with COVID-19 between March and July 2020. The median age of the COVID-19 subgroup was 34 years, 43 were adult patients and 10 were paediatric, 58% had complex congenital anatomy, 15% had a genetic syndrome, 11% had pulmonary hypertension, and 17% were obese. 

Patient outcomes were as follows: nine participants (17%) developed moderate/severe infection and three patients (6%) died. Upon analysis of the dataset, both a concurrent genetic syndrome in all patients and advanced physiologic stage in adult patients were linked to an increased risk of symptom severity.  

The researchers therefore 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.” 

The authors did, however, note that limitations of their study include small sample size and a patient population that probably adhered to stricter social distancing practice, as well as the CHD community being, on average, younger than the general population 

Despite this, they still remained reassured by the low number of patients who presented at the centre with COVID-19 and the subsequent patient outcomes because: “At the beginning of the pandemic, many feared that CHD would be as big a risk factor for COVID-19 as adult-onset cardiovascular disease.”