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


Adults and children born with heart defects had a lower than expected risk of developing moderate or severe symptoms of COVID-19, according to a study of more than 7,000 patients at the Congenital Heart Center at Columbia University Vagelos College of Physicians and Surgeons.

The study was published online on October 14 in the Journal of the American Heart Association.

Throughout the pandemic, evidence has shown that people with heart disease have a higher risk of fatal illness and complications from COVID-19. But the impact of SARS-CoV-2 infection on people with congenital heart defects, who are typically younger than those with heart disease in adulthood, was unknown.

“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,” explains Matthew Lewis, MD, assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and study co-lead. “We were reassured by the low number of congenital heart patients who had to be hospitalized for COVID-19 and the relatively good results of these patients. “

Few congenital heart patients had COVID-19

Only 53 congenital heart patients (43 adults and 10 children) – less than 0.8% of Columbia Congenital Heart Center patients – presented symptoms of SARS-CoV-2 infection to their doctors from March to June. . (During the study period, an estimated 20% of people in the New York metro area were infected with the coronavirus.)

Over 80% (43) of these patients presented mild symptoms. Of the nine patients who developed moderate to severe symptoms, three died. (Another study done at Columbia during the same time period found that about 22% of hospital patients in the general population became seriously ill, and about a third of those patients died.)

In the new study, researchers 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 defect An individual’s congenital heart disease does not impact the severity of symptoms.

Although the study sample is small, the researchers conclude that congenital heart disease on its own may not be enough to increase the risk of severe symptoms of COVID-19.

Warnings

People with congenital heart disease are unlikely to have an inherently lower risk of becoming seriously ill from the novel coronavirus, and the researchers hypothesize that patients in this study may have adhered more strictly to the guidelines. social distancing from the general population, given the publicity about the increased risk of COVID-19 in patients with heart disease. The researchers warn that people with congenital heart disease should continue to practice strict social distancing and follow all CDC guidelines, as those measures likely contributed to the study’s results.

They also note that the younger average age (34 years) of these patients and a lower incidence of acquired cardiac risk factors compared to others who had severe COVID-19 may explain why fewer congenital heart patients. than expected had severe symptoms.

“It is possible that elderly patients with congenital heart disease have a different risk profile than the general population,” adds Brett Anderson, MD, MBA, Florence Irving Assistant Professor of Pediatrics at Columbia University Vagelos College of Physicians and Surgeons and co-lead of the study. “We have not yet defined what these risk factors are.”