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. 2023 Mar:11:100428.
doi: 10.1016/j.ijcchd.2022.100428. Epub 2022 Nov 21.

The coronavirus disease pandemic among adult congenital heart disease patients and the lessons learnt - results of a prospective multicenter european registry

Francisco Javier Ruperti-Repilado  1   2 , Helmut Baumgartner  3 , Berto Bouma  4 , Judith Bouchardy  5   6 , Werner Budts  7   8 , Laurence Campens  9 , Massimo Chessa  10   11 , Maria Jesús Del Cerro Marin  12 , Harald Gabriel  13 , Pastora Gallego  14 , Elvira Ana González  15 , Annette Schophuus Jensen  16 , Magalie Ladouceur  17 , Christopher Lockhart  18 , Berta Miranda-Barrio  19 , Marielle Morissens  20 , Eduardo Moreno Escobar  21 , Agnès Pasquet  22 , Joaquin Rueda Soriano  23 , Annemien Elise van den Bosch  24 , Heleen Berdina van der Zwaan  25 , Daniel Tobler  2 , Matthias Greutmann  26 , Markus Schwerzmann  1
Affiliations

The coronavirus disease pandemic among adult congenital heart disease patients and the lessons learnt - results of a prospective multicenter european registry

Francisco Javier Ruperti-Repilado et al. Int J Cardiol Congenit Heart Dis. 2023 Mar.

Abstract

Background: At the beginning of the COVID-19 pandemic, professionals in charge of particularly vulnerable populations, such as adult congenital heart disease (ACHD) patients, were confronted with difficult decision-making. We aimed to assess changes in risk stratification and outcomes of ACHD patients suffering from COVID-19 between March 2020 and April 2021.

Methods and results: Risk stratification among ACHD experts (before and after the first outcome data were available) was assessed by means of questionnaires. In addition, COVID-19 cases and the corresponding patient characteristics were recorded among participating centres. Predictors for the outcome of interest (complicated disease course) were assessed by means of multivariable logistic regression models calculated with cluster-robust standard errors. When assessing the importance of general and ACHD specific risk factors for a complicated disease course, their overall importance and the corresponding risk perception among ACHD experts decreased over time. Overall, 638 patients (n = 168 during the first wave and n = 470 during the subsequent waves) were included (median age 34 years, 52% women). Main independent predictors for a complicated disease course were male sex, increasing age, a BMI >25 kg/m2, having ≥2 comorbidities, suffering from a cyanotic heart disease or having suffered COVID-19 in the first wave vs. subsequent waves.

Conclusions: Apart from cyanotic heart disease, general risk factors for poor outcome in case of COVID-19 reported in the general population are equally important among ACHD patients. Risk perception among ACHD experts decreased during the course of the pandemic.

Keywords: Adult congenital heart disease; Coronavirus disease 2019; Outcomes; Risk stratification.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Professor Werner Budts reports financial support was provided by Abbott and Occlutech. Following co-authors: Dr. Pastora Gallego, Dr. Magalie Ladouceur, Dr. Massimo Chessa, Professor Werner Budts and Prof. Helmut Baumgartner are Associate Editors and, therefore, members of the Editorial Board of the International Journal of Cardiology Congenital Heart Disease.

Figures

Fig. 1
Fig. 1
Comparison between surveys of answers related to general cardiovascular and ACHD-specific risk factors (a) and risk stratification among ACHD possible clinical scenarios (b). ACHD = adult congenital heart disease; AICD = automated implantable cardioverter defibrillator; EF = ejection fraction; Fontan-TCPC means univentricular physiology with total cavopulmonary connection and good hemodynamics; TOF-Conduit – repaired Tetralogy of Fallot with conduit implantation; TOF-PR – repaired Tetralogy of Fallot with residual severe pulmonary regurgitation; Repaired CoA – repaired aortic coarctation with mild residual hypertension; VSD-NC – repaired ventricular septal defect and mild non-compaction cardiomyopathy.
Fig. 2
Fig. 2
Proportion of cases with a complicated disease course. CHD = congenital heart defect; ES = Eisenmenger syndrome; TGA = transposition of the great arteries; TOF = tetralogy of Fallot.
See this image and copyright information in PMC

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