Congenital heart defects may double risk of critical COVID-19 illness in hospitalized patients

March 07, 2022

3 minute read


Disclosures: The authors report no relevant financial information.

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According to a study published in Traffic.

In a research letter, the authors noted that among people with congenital heart defects, critical COVID-19 outcomes, defined as ICU admission, ventilator use, or death, were higher. common in those who were older or who also had other conditions like HF, pulmonary hypertension, Down syndrome, diabetes, or obesity; however, children and adults with heart defects without these conditions were still at increased risk.

Child receiving the COVID vaccine

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Karrie f. downing

“Given the increased risk of critical outcomes from COVID-19 disease in patients with heart defects, healthcare providers should encourage their patients with heart defects to get vaccinated and discuss with their patients the need other preventive measures to avoid infection”, Karrie f. Downing, MPH, an epidemiologist from the CDC’s National Center for Birth Defects and Developmental Disabilities, told Healio. “In addition, people with heart defects should discuss with their health care provider what steps they can take to manage their health and risks. Vaccination and other preventive measures against COVID-19 are important for patients with heart defects, especially those with multiple or serious health conditions. Clinicians and patients can also check the CDC’s website regularly for updated guidance.

Downing and colleagues compared the prevalence of COVID-19 critical illness period among 235,638 hospitalized patients with COVID-19 with and without congenital heart disease from March 2020 to January 2021, using data from the COVID-19 Special Version from the Premier Healthcare Database, an all-payer database representing 20% ​​of hospital admissions in the United States. Among patients with congenital heart disease, researchers also assessed features associated with critical illness from COVID-19.

Within the cohort, 421 (0.2%) had congenital heart defects. Among these patients, 68.4% had at least one comorbidity and 12.8% were children. Among those without congenital heart disease, 58.8% had at least one comorbidity and 1.4% were children.

Among patients with congenital heart defects and COVID-19, 53.9% were admitted to intensive care, 24% required invasive mechanical ventilation and 11.2% died during hospitalization.

After adjustment, in patients with COVID-19, ICU admission (adjusted prevalence ratio [aPR], 1.4; 95% CI, 1.2-1.6), invasive mechanical ventilation (aPR, 1.8; 95% CI, 1.3-2.6) and death (aPR, 2; 95% CI , 1.3-3.2) were more common in patients with congenital heart defects compared to those without. When stratified by high-risk characteristics, prevalence estimates of ICU admissions, mechanical ventilation, and deaths remained higher in COVID-19 patients with congenital heart defects compared to those without. congenital heart defects, including for those without IC, pulmonary hypertension, Down syndrome, diabetes, or obesity.

“Current analyzes compared the prevalence of critical COVID-19 period between patients with and without congenital heart defects in the same hospitals, adjusted and stratified by established high-risk factors for severe COVID-19 infection and found found an adjusted prevalence up to twice as high. of critical COVID-19 in patients with congenital heart defects, although the findings are specific to hospitalized patients,” the researchers wrote.

The researchers noted that targeted strategies are needed to increase awareness of congenital heart defects as a risk factor for severe COVID-19 disease and highlight the critical importance of COVID-19 disease prevention for people. with congenital heart defects and their families through vaccination, masking and physical distancing.

“Not all hospitalized COVID-19 patients with heart defects performed poorly in our analysis, so more work is needed to identify why the clinical course of COVID-19 disease drives ICU admission. , the need for a ventilator or the death of some hospitalized. patients with risk factors for severe COVID-19 disease, such as heart defects, and not for others,” Downing told Healio. “In addition, the study population were hospitalized patients with COVID-19. Therefore, research to determine whether people with COVID-19 and heart defects are more likely to be hospitalized than people with COVID-19 without heart defects is needed.

For more information:

Karrie f. Downing, MPH, can be contacted at [email protected]; Twitter: @CDC_NCBDDD.