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. 2020 Jun 8;9(6):1774.
doi: 10.3390/jcm9061774.

COVID-19 and Congenital Heart Disease: Results from a Nationwide Survey

Jolanda Sabatino  1 , Paolo Ferrero  2 , Massimo Chessa  3 , Francesco Bianco  4 , Paolo Ciliberti  5 , Aurelio Secinaro  6 , Lilia Oreto  7 , Martina Avesani  8 , Valentina Bucciarelli  4 , Giuseppe Calcaterra  9 , Maria Pia Calabrò  10 , Maria Giovanna Russo  11 , Pier Paolo Bassareo  12 , Paolo Guccione  5 , Ciro Indolfi  1 , Giovanni Di Salvo  8
Affiliations

COVID-19 and Congenital Heart Disease: Results from a Nationwide Survey

Jolanda Sabatino et al. J Clin Med. .

Abstract

Background: The pandemic of Novel Coronavirus Disease 2019 (COVID-19) is challenging, given the large number of hospitalized patients. Cardiovascular co-morbidities are linked to a higher mortality risk. Thus, patients with Congenital Heart Disease (CHD) might represent a high-risk population. Nevertheless, no data about them are available, yet. Hence, we conducted a nationwide survey to assess clinical characteristics and outcomes in patients with congenital heart disease affected by COVID-19.

Methods and results: This is a multi-centre, observational, nationwide survey, involving high-volume Italian CHD centres. COVID-19 diagnosis was defined as either "clinically suspected" or "confirmed", where a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) test had been performed and was positive. Cardiovascular comorbidities were observed among adult patients-atrial fibrillation (seven; 9%), hypertension (five; 7%), obesity (seven; 9%) and diabetes (one; 1%)-but were absent among children. Cardiovascular complications were mainly observed in the "confirmed" COVID-19+ group, consisting of heart failure (9%), palpitations/arrhythmias (3%), stroke/TIA (3%) and pulmonary hypertension (3%). Cardiovascular symptoms such as chest pain (1%), myocardial injury (1%) and pericardial effusion (1%) were also recorded. On the contrary, CHD patients from the clinically suspected COVID-19 group presented no severe symptoms or complications.

Conclusions: Despite previous reports pointing to a higher case-fatality rate among patients with cardiovascular co-morbidities, we observed a mild COVID-19 clinical course in our cohort of CHD patients. Although these results should be confirmed in larger cohorts to investigate the underlying mechanisms, the findings of low cardiovascular complications rates and no deaths are reassuring for CHD patients.

Keywords: COVID-19; cardiovascular complications; congenital heart disease.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Congenital Heart Disease distribution on admission to high-volume Italian CHD centres with “clinically suspected” or “confirmed” COVID-19 diagnoses. CHD = Congenital Heart Disease; ASD = atrial septal defect; VSD = ventricular septal defect; PA = pulmonary stenosis; AS/BAV = aortic stenosis/bicuspid aortic valve; COA = coarctation of the aorta; DORV = double outlet right ventricle; TOF = tetralogy of Fallot; TGA = transposition of the great arteries; ccTGA = congenitally corrected transposition of the great arteries; AVSD = atrioventricular septal defect; TCPC = total cavopulmonary connection; CHD-Covid-19+ = confirmed diagnosis of COVID-19; suspCHD-Covid-19 = clinically suspected COVID-19 (no confirmation test available during the outbreak).
Figure 2
Figure 2
Cardiovascular complications of patients with congenital heart disease and CHD-Covid-19+ (confirmed diagnosis of COVID-19) or suspCHD-Covid-19 (clinically suspected COVID-19). N = number of cases.
Figure 3
Figure 3
Clinical manifestations and outcome of patients with Congenital Heart Disease and “clinically suspected” or “confirmed” COVID-19 diagnosis.
See this image and copyright information in PMC

References

    1. Wang C., Horby P.W., Hayden F.G., Gao G.F. A novel coronavirus outbreak of global health concern. Lancet. 2020;395:470–473. doi: 10.1016/S0140-6736(20)30185-9. - DOI - PMC - PubMed
    1. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., Zhao X., Huang B., Shi W., Lu R., et al. A novel coronavirus from patients with pneumonia in China, 2019. N. Engl. J. Med. 2020;382:727–733. doi: 10.1056/NEJMoa2001017. - DOI - PMC - PubMed
    1. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J., Wang B., Xiang H., Cheng Z., Xiong Y., et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 doi: 10.1001/jama.2020.1585. - DOI - PMC - PubMed
    1. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., Liu L., Shan H., Lei C.L., Hui D.S., et al. Clinical characteristics of coronavirus disease 2019 in China. N. Engl. J. Med. 2020 doi: 10.1056/NEJMoa2002032. - DOI - PMC - PubMed
    1. Guo T., Fan Y., Chen M., Wu X., Zhang L., He T., Wang H., Wan J., Wang X., Lu Z. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19) JAMA Cardiol. 2020 doi: 10.1001/jamacardio.2020.1017. - DOI - PMC - PubMed

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