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. 2023 Jul;10(2):e002356.
doi: 10.1136/openhrt-2023-002356.

COVID-19 in congenital heart disease (COaCHeD) study

Sian Chivers  1   2 , Aoife Cleary  2   3 , Rachel Knowles  4   5 , Sonya V Babu-Narayan  1   6 , John M Simpson  2 , Heba Nashat  7 , Konstantinos Dimopoulos  7 , Michael A Gatzoulis  7 , Dirk Wilson  8 , Milos Prica  9 , James Anthony  10 , Paul F Clift  10 , Victoria Jowett  3 , Petra Jenkins  11 , Bernadette Khodaghalian  12 , Caroline B Jones  12 , Antonia Hardiman  13 , Catherine Head  13 , Owen Miller  2 , Natali Ay Chung  14 , Umar Mahmood  15 , Frances A Bu'Lock  15 , Tristan Kw Ramcharan  16 , Ashish Chikermane  17 , Jennifer Shortland  18 , Andrew Tometzki  18 , David S Crossland  19 , Zdenka Reinhardt  19 , Clive Lewis  20 , Leila Rittey  21 , Dominic Hares  22 , Olga Panagiotopoulou  23 , Benjamin Smith  23 , Muhammad Najih L  24 , Tara Bharucha  24 , Piers Ef Daubeney  25
Affiliations

COVID-19 in congenital heart disease (COaCHeD) study

Sian Chivers et al. Open Heart. 2023 Jul.

Abstract

Background: COVID-19 has caused significant worldwide morbidity and mortality. Congenital heart disease (CHD) is likely to increase vulnerability and understanding the predictors of adverse outcomes is key to optimising care.

Objective: Ascertain the impact of COVID-19 on people with CHD and define risk factors for adverse outcomes.

Methods: Multicentre UK study undertaken 1 March 2020-30 June 2021 during the COVID-19 pandemic. Data were collected on CHD diagnoses, clinical presentation and outcomes. Multivariable logistic regression with multiple imputation was performed to explore predictors of death and hospitalisation.

Results: There were 405 reported cases (127 paediatric/278 adult). In children (age <16 years), there were 5 (3.9%) deaths. Adjusted ORs (AORs) for hospitalisation in children were significantly lower with each ascending year of age (OR 0.85, 95% CI 0.75 to 0.96 (p<0.01)). In adults, there were 24 (8.6%) deaths (19 with comorbidities) and 74 (26.6%) hospital admissions. AORs for death in adults were significantly increased with each year of age (OR 1.05, 95% CI 1.01 to 1.10 (p<0.01)) and with pulmonary arterial hypertension (PAH; OR 5.99, 95% CI 1.34 to 26.91 (p=0.02)). AORs for hospitalisation in adults were significantly higher with each additional year of age (OR 1.03, 95% CI 1.00 to 1.05 (p=0.04)), additional comorbidities (OR 3.23, 95% CI 1.31 to 7.97 (p=0.01)) and genetic disease (OR 2.87, 95% CI 1.04 to 7.94 (p=0.04)).

Conclusions: Children were at low risk of death and hospitalisation secondary to COVID-19 even with severe CHD, but hospital admission rates were higher in younger children, independent of comorbidity. In adults, higher likelihood of death was associated with increasing age and PAH, and of hospitalisation with age, comorbidities and genetic disease. An individualised approach, based on age and comorbidities, should be taken to COVID-19 management in patients with CHD.

Keywords: COVID-19; EPIDEMIOLOGY; Heart Defects, Congenital; RISK FACTORS.

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Conflict of interest statement

Competing interests: None declared.

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