1. Clinical outcome of COVID-19 in patients with adult congenital heart disease
- Author
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Schwerzmann M, Ruperti-Repilado FJ, Baumgartner H, Bouma B, Bouchardy J, Budts W, Campens L, Chessa M, Del Cerro Marin MJ, Gabriel H, Gallego P, Garcia-Orta R, Gonzalez AE, Jensen AS, Ladouceur M, Miranda-Barrio B, Morissens M, Pasquet A, Rueda J, van den Bosch AE, van der Zwaan HB, Tobler D, Greutmann M, EPOCH, Cardiology, ACS - Heart failure & arrhythmias, ACS - Pulmonary hypertension & thrombosis, Schwerzmann, M., Ruperti-Repilado, F. J., Baumgartner, H., Bouma, B., Bouchardy, J., Budts, W., Campens, L., Chessa, M., Del Cerro Marin, M. J., Gabriel, H., Gallego, P., Garcia-Orta, R., Gonzalez, A. E., Jensen, A. S., Ladouceur, M., Miranda-Barrio, B., Morissens, M., Pasquet, A., Rueda, J., Van Den Bosch, A. E., Van Der Zwaan, H. B., Tobler, D., Greutmann, M., UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Institut Català de la Salut, [Schwerzmann M, Ruperti-Repilado FJ] Center for Congenital Heart Disease, Inselspital University Hospital, Bern, Switzerland. Dept. of Cardiology III - Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Munster, Nordrhein-Westfalen, Germany. [Baumgartner H] Dept. of Cardiology III - Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Munster, Nordrhein-Westfalen, Germany. [Bouma B] Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. [Bouchardy J] Department of Cardiology and Cardiac Surgery, Lausanne University Hospital, Lausanne, Switzerland. Division of Cardiology, University Hospital of Geneva, Geneva, Switzerland. [Budts W] Congenital and Structural Cardiology, University Hospital Leuven, Leuven, Flanders, Belgium. Department of Cardiovascular Sciences, Catholic University Leuven, Leuven, Flanders, Belgium. [Miranda-Barrio B] Unitat de Cardiopaties Congènites de l’Adult, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Santa Creu i Sant Pau University Hospital, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Inotrope ,Pediatrics ,medicine.medical_specialty ,Cardiac & Cardiovascular Systems ,Heart disease ,Coronavirus disease 2019 (COVID-19) ,Cardiopatia congènita ,Cardiologie et circulation ,610 Medicine & health ,030204 cardiovascular system & hematology ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Natural Science Disciplines::Science::Research::Biomedical Research::Outcome Assessment (Health Care) [DISCIPLINES AND OCCUPATIONS] ,SDG 3 - Good Health and Well-being ,medicine ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Medicine and Health Sciences ,030212 general & internal medicine ,congenital, heart defects ,POPULATION ,COVID-19 (Malaltia) - Complicacions ,Science & Technology ,business.industry ,DEATH ,congenital ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,CARE ,medicine.disease ,Obesity ,Eisenmenger syndrome ,disciplinas de las ciencias naturales::ciencia::investigación::investigación biomédica::evaluación del desenlace (asistencia sanitaria) [DISCIPLINAS Y OCUPACIONES] ,Cohort ,Avaluació de resultats (Assistència sanitària) ,Cardiovascular System & Cardiology ,heart defects ,business ,Cardiology and Cardiovascular Medicine ,Body mass index ,Life Sciences & Biomedicine ,Congenital, Hereditary, and Neonatal Diseases and Abnormalities::Congenital Abnormalities::Cardiovascular Abnormalities::Heart Defects, Congenital [DISEASES] ,enfermedades y anomalías neonatales congénitas y hereditarias::anomalías congénitas::anomalías cardiovasculares::cardiopatías congénitas [ENFERMEDADES] - Abstract
[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., The European Collaboration for Prospective Outcome Research in Congenital Heart Disease is funded by internal grants without support from the pharmaceutical industry.
- Published
- 2021