Congenital heart defects may not increase risk of severe COVID-19

Rather than having an inherently lower risk of severe COVID-19, patients in the study may have adhered more strictly to social distancing guidelines compared to the general population.

Contrary to concerns at the start of the pandemic, a new study has found that adults and children born with heart defects had lower than expected risks of developing moderate or severe symptoms of coronavirus disease 2019 (COVID-19) , according to a study conducted by Columbia University Irving Medical Center.

Several studies have shown that people with heart disease are at higher risk of life-threatening illnesses and complications from COVID-19, although the impact of the disease on people with congenital heart defects is unknown. According to the study, approximately 1% of infants born each year in the United States have 1 or more heart defects.

“At the start of the pandemic, many feared that congenital heart disease was as important a risk factor for severe COVID-19 as adult cardiovascular disease,” said Matthew Lewis, MD, co-lead of the study, in a press. Release. “We were reassured by the low number of congenital heart patients who required hospitalization for COVID-19 and the relatively good outcomes of these patients.”

The study included more than 7,000 patients from Columbia University’s Vagelos College of Physicians and Surgeons Congenital Heart Center. Of these, only 53 patients (43 adults and 10 children) presented to their physician with symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between March and June 2020. During the period of According to the study, approximately 20% of people in the New York metropolitan area were believed to have been infected with COVID-19, a significant difference from the less than 0.8% of patients at the Columbia Congenital Heart Center.

Of the 53 patients, 43 (80%) had mild symptoms. Of the 9 patients who developed moderate to severe symptoms, 3 died. In comparison, another study conducted during the same period found that about 22% of hospitalized patients in the general population fell into critical condition and about a third of these patients died.

The current study also found that patients with a genetic syndrome and adults with advanced disease due to their congenital heart defect were more likely to develop moderate to severe symptoms, although the type of congenital heart defect of an individual does not affect the severity of symptoms. Although they acknowledged that the study sample was small, the researchers concluded that congenital heart disease alone may not be enough to increase the risk of severe COVID-19 symptoms.

The study authors added, however, that people with congenital heart disease are unlikely to have an inherently lower risk of becoming seriously ill from COVID-19. They speculated that the patients in the study may have adhered more strictly to social distancing guidelines compared to the general population, given the publicity about the increased risk of COVID-19 in patients with heart disease. In a press release, the researchers warned that people with congenital heart disease should continue to practice strict social distancing and follow all CDC guidelines.

They also said that the younger average age of these patients and a lower incidence of acquired cardiac risk factors compared to others with severe COVID-19 may explain why fewer congenital heart patients had severe symptoms. .

“It is possible that elderly patients with congenital heart disease have a different risk profile than the general population,” Brett Anderson, MD, MS, MBA, study co-lead, said in a press release. . “We still need to define what those risk factors are.”

REFERENCE

Congenital heart defects may not increase risk of severe COVID-19 symptoms [news release]. EurekAlert; October 16, 2020. https://www.eurekalert.org/pub_releases/2020-10/cuim-chd101620.php. Accessed January 27, 2021.