TY - JOUR
T1 - Clinical outcome of COVID-19 in patients with adult congenital heart disease
AU - Schwerzmann, Markus
AU - Ruperti-Repilado, Francisco Javier
AU - Baumgartner, Helmut
AU - Bouma, Berto
AU - Bouchardy, Judith
AU - Budts, Werner
AU - Campens, Laurence
AU - Chessa, Massimo
AU - Del Cerro Marin, Maria Jesús
AU - Gabriel, Harald
AU - Gallego, Pastora
AU - Garcia-Orta, Rocio
AU - Gonzalez, Ana Elvira
AU - Jensen, Annette Schophuus
AU - Ladouceur, Magalie
AU - Miranda-Barrio, Berta
AU - Morissens, Marielle
AU - Pasquet, Agnes
AU - Rueda, Joaquín
AU - van den Bosch, Annemien E
AU - van der Zwaan, Heleen Berdina
AU - Tobler, Daniel
AU - Greutmann, Matthias
AU - EPOCH
N1 - © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/7/12
Y1 - 2021/7/12
N2 - AIMS: Patients with adult congenital heart disease (ACHD) are a potentially vulnerable patient cohort in case of COVID-19. Some cardiac defects may be associated with a poor COVID-19 outcome. Risk estimation in ACHD is currently based on expert opinion. The aim of this study was to collect clinical outcome data and to identify risk factors for a complicated course of COVID-19 in patients with ACHD.METHODS: Twenty-five ACHD centres in nine European countries participated in the study. Consecutive patients with ACHD diagnosed with COVID-19 presenting to one of the participating centres between 27 March and 6 June 2020 were included. A complicated disease course was defined as hospitalisation for COVID-19 requiring non-invasive or invasive ventilation and/or inotropic support, or a fatal outcome.RESULTS: Of 105 patients with a mean age of 38±13 years (58% women), 13 had a complicated disease course, of whom 5 died. In univariable analysis, age (OR 1.3, 95% CI 1.1 to 1.7, per 5 years), ≥2 comorbidities (OR 7.1, 95% CI 2.1 to 24.5), body mass index of >25 kg/m2 (OR 7.2, 95% CI 1.9 to 28.3) and cyanotic heart disease (OR 13.2, 95% CI 2.5 to 68.4) were associated with a complicated disease course. In a multivariable logistic regression model, cyanotic heart disease was the most important predictor (OR 60.0, 95% CI 7.6 to 474.0).CONCLUSIONS: Among patients with ACHD, general risk factors (age, obesity and multiple comorbidities) are associated with an increased risk of complicated COVID-19 course. Congenital cardiac defects at particularly high risk were cyanotic lesions, including unrepaired cyanotic defects or Eisenmenger syndrome.
AB - AIMS: Patients with adult congenital heart disease (ACHD) are a potentially vulnerable patient cohort in case of COVID-19. Some cardiac defects may be associated with a poor COVID-19 outcome. Risk estimation in ACHD is currently based on expert opinion. The aim of this study was to collect clinical outcome data and to identify risk factors for a complicated course of COVID-19 in patients with ACHD.METHODS: Twenty-five ACHD centres in nine European countries participated in the study. Consecutive patients with ACHD diagnosed with COVID-19 presenting to one of the participating centres between 27 March and 6 June 2020 were included. A complicated disease course was defined as hospitalisation for COVID-19 requiring non-invasive or invasive ventilation and/or inotropic support, or a fatal outcome.RESULTS: Of 105 patients with a mean age of 38±13 years (58% women), 13 had a complicated disease course, of whom 5 died. In univariable analysis, age (OR 1.3, 95% CI 1.1 to 1.7, per 5 years), ≥2 comorbidities (OR 7.1, 95% CI 2.1 to 24.5), body mass index of >25 kg/m2 (OR 7.2, 95% CI 1.9 to 28.3) and cyanotic heart disease (OR 13.2, 95% CI 2.5 to 68.4) were associated with a complicated disease course. In a multivariable logistic regression model, cyanotic heart disease was the most important predictor (OR 60.0, 95% CI 7.6 to 474.0).CONCLUSIONS: Among patients with ACHD, general risk factors (age, obesity and multiple comorbidities) are associated with an increased risk of complicated COVID-19 course. Congenital cardiac defects at particularly high risk were cyanotic lesions, including unrepaired cyanotic defects or Eisenmenger syndrome.
KW - congenital
KW - heart defects
UR - http://www.scopus.com/inward/record.url?scp=85102268037&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2020-318467
DO - 10.1136/heartjnl-2020-318467
M3 - Journal article
C2 - 33685931
SN - 1355-6037
VL - 107
SP - 1226
EP - 1232
JO - Heart (British Cardiac Society)
JF - Heart (British Cardiac Society)
IS - 15
ER -