COVID-19 often more severe with congenital heart defects

Adults with congenital heart defect (CHD) are at increased risk of severe illness and death when hospitalized with COVID-19, making vaccination and other preventative measures even more important in this population. , say researchers from the US Centers for Disease Control and Prevention (CDC). ).

Karrie Downing MPH

“We found that hospitalized patients with heart defects are up to twice as likely to have critical COVID-19 disease outcomes (admission to the intensive care unit, use of a ventilator to help breathing or death) compared to hospitalized COVID-19 patients without heart defects,” said Karrie Downing, MPH, epidemiologist at the CDC’s National Center for Birth Defects and Developmental Disabilities. | Medscape Cardiology.

“Additionally, we learned that people with heart defects who were older or who also had other conditions like heart failure, pulmonary hypertension, Down syndrome, diabetes, or obesity were the more likely to have critical COVID-19 disease, but children and adults with the heart defects without these other conditions were still at increased risk,” Downing said.

The message for healthcare providers is clear: “Encourage your patients with heart defects to get vaccinated and discuss with your patients the need for other preventive measures to avoid infection that could progress to COVID-19 disease. serious,” Downing added.

The study was published online March 7 in Traffic.

The researchers analyzed data on 235,638 patients hospitalized with COVID-19 between March 2020 and January 2021, including 421 (0.2%) with CHD.

Most coronary patients were over the age of 30 (73%) and 61% were male, including 55% non-Hispanic white, 19% Hispanic, and 16% non-Hispanic black.

Overall, 68% of coronary patients had at least one comorbidity, as did 59% of patients without coronary artery disease.

Intensive care unit (ICU) admission rates were higher in the CHD group (54% versus 43%), as were rates of invasive mechanical ventilation (24% versus 15%) and in-hospital death (11% versus 7%).

After controlling for patient characteristics, ICU admission, invasive mechanical ventilation, and death were more common among COVID-19 patients with than without CHD, with adjusted prevalence rates of 1.4, 1, 8 and 2.0, respectively.

When stratified by high-risk characteristics, prevalence estimates for ICU admission, invasive mechanical ventilation, and death remained higher in patients with COVID-19 and CHD in almost all strata, including younger age groups and those without heart failure, pulmonary hypertension, Down syndrome, diabetes or obesity, the researchers report.

Downing said more work is needed to identify why the clinical course of COVID-19 disease leads to ICU admission, the need for a ventilator or death in some hospitalized patients with coronary artery disease and not to others.

“There could be a number of social, environmental, economic, medical and genetic factors playing a role. But staying up to date with COVID-19 vaccines and following preventative measures for COVID-19 are effective ways to reduce risk. severe illness from COVID-19,” Downing said.

The study had no specific funding. The authors report no relevant disclosures.

Traffic. Published online March 7, 2022. Summary.

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