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COVID-19 in Adults With Congenital Heart Disease

2021; Elsevier BV; Volume: 77; Issue: 13 Linguagem: Inglês

10.1016/j.jacc.2021.02.023

1558-3597

Craig S. Broberg, Adrienne H. Kovacs, Soraya Sadeghi, Marlon Rosenbaum, Matthew Lewis, Matthew Carazo, Fred H. Rodriguez, Dan Halpern, Jodi L. Feinberg, Francisca Arancibia G., Fernando Baraona, Ari Cedars, Jong Mi Ko, Prashob Porayette, Jennifer Maldonado, Berardo Sarubbi, Flavia Fusco, Alexandra Frogoudaki, Amiram Nir, Anisa Chaudhry, Anitha S. John, Abdolreza Karbassi, Arvind Hoskoppal, Benjamin P. Frischhertz, Benjamin Hendrickson, Berto J. Bouma, Carla P. Rodríguez-Monserrate, Christopher R. Broda, Daniel Tobler, David Gregg, Efrén Martínez‐Quintana, Elizabeth Yeung, Eric V. Krieger, Francisco Javier Ruperti‐Repilado, George Giannakoulas, George K. Lui, Georges Ephrem, Harsimran Singh, Hassan Almeneisi, Heather L. Bartlett, Ian Lindsay, Jasmine Grewal, Jeremy Nicolarsen, John Jairo Araujo, Jonathan Cramer, Judith Bouchardy, Khalid Al Najashi, Kristi K. Ryan, Laith Alshawabkeh, Lauren Andrade, Magalie Ladouceur, Markus Schwerzmann, Matthias Greutmann, Pablo Merás, Paolo Ferrero, Payam Dehghani, Poyee P. Tung, Rocío García‐Orta, Rose Tompkins, Salwa Gendi, Scott B. Cohen, Scott E. Klewer, Sébastien Hascoët, Shabnam Mohammadzadeh, Shailendra Upadhyay, Stacy D. Fisher, Stephen C. Cook, Timothy B. Cotts, Jamil Aboulhosn,

COVID-19 Clinical Research Studies

Adults with congenital heart disease (CHD) have been considered potentially high risk for novel coronavirus disease-19 (COVID-19) mortality or other complications.This study sought to define the impact of COVID-19 in adults with CHD and to identify risk factors associated with adverse outcomes.Adults (age 18 years or older) with CHD and with confirmed or clinically suspected COVID-19 were included from CHD centers worldwide. Data collection included anatomic diagnosis and subsequent interventions, comorbidities, medications, echocardiographic findings, presenting symptoms, course of illness, and outcomes. Predictors of death or severe infection were determined.From 58 adult CHD centers, the study included 1,044 infected patients (age: 35.1 ± 13.0 years; range 18 to 86 years; 51% women), 87% of whom had laboratory-confirmed coronavirus infection. The cohort included 118 (11%) patients with single ventricle and/or Fontan physiology, 87 (8%) patients with cyanosis, and 73 (7%) patients with pulmonary hypertension. There were 24 COVID-related deaths (case/fatality: 2.3%; 95% confidence interval: 1.4% to 3.2%). Factors associated with death included male sex, diabetes, cyanosis, pulmonary hypertension, renal insufficiency, and previous hospital admission for heart failure. Worse physiological stage was associated with mortality (p = 0.001), whereas anatomic complexity or defect group were not.COVID-19 mortality in adults with CHD is commensurate with the general population. The most vulnerable patients are those with worse physiological stage, such as cyanosis and pulmonary hypertension, whereas anatomic complexity does not appear to predict infection severity.