People with heart defects may be at higher risk of serious illness from COVID-19

People with a congenital heart defect who were hospitalized with a COVID-19 infection were at greater risk of severe illness or death than those without a heart defect, new research published today in the journal’s flagship journal ‘American Heart Association, peer-reviewed. Traffic. Researchers found that people with a congenital heart defect who had contracted COVID-19 were also more likely to require intensive care unit (ICU) treatment or need a ventilator.

According to the study, among those most at risk of contracting the most severe COVID-19 disease were patients who had a heart defect and another health condition, were aged 50 and older, or were men.

There are more than a dozen types of congenital heart defects, which occur when the heart or blood vessels near the heart do not develop normally before birth. According to the American Heart Association’s Heart Disease and Stroke Statistics 2022 Update, congenital heart defects are the most common birth defect in the world, with a global prevalence of 157 per 100,000 in 2017.

“Data comparing COVID-19 outcomes in people with and without congenital heart defects have been limited,” said lead author Karrie Downing, MPH, epidemiologist at the National Center on Birth Defects and Developmental Disabilities and the team. COVID-19 response in the United States. Centers for Disease Control and Prevention in Atlanta.

Researchers looked at data on COVID-19 hospitalized patients from March 2020 to January 2021, collected in the special COVID-19 version of the Premier Healthcare database, a database representing approximately 20% of all hospitalizations in the States. -United. COVID-19 patients with and without heart defects in this study received care at the same hospitals. Differences in age, gender, race/ethnicity, types of health insurance, and other high-risk conditions (especially heart failure, pulmonary hypertension, Down syndrome, diabetes, and obesity) were taken into account in these populations.

During this period, the database had more than 235,000 patients, ages 1 to 64, who were hospitalized with COVID-19. The patients were divided into two groups: those who had a congenital heart defect and those who did not. Within these two categories, the researchers then determined how many people required admission to intensive care, needed a ventilator to help with breathing, or died. The researchers also looked at other characteristics, including other health conditions.

Of the 235,638 hospitalized COVID-19 patients evaluated for this study, 421 or 0.2% had a congenital heart defect. The analysis found:

  • among patients with heart defects, most were over 30 years old (73%) and 61% were men; 55% were non-Hispanic white, 19% were Hispanic, and 16% were non-Hispanic black;
  • overall, 68% of patients with a heart defect also had at least one other noted health condition, compared with 59% of those without a congenital heart defect;
  • 54% of patients with a congenital heart defect were admitted to intensive care, compared to 43% of those without a congenital heart defect;
  • 24% of patients with a congenital heart defect needed a ventilator to breathe, compared to 15% of those without a congenital heart defect; and
  • 11% of patients with a congenital heart defect died during hospitalization compared to 7% of those without a congenital heart defect.

Additionally, people with congenital heart defects still remained at high risk for severe COVID-19 illness, even when categorized by age or other health conditions noted in the study, according to Researchers.

Downing believes these findings have immediate and practical relevance for healthcare professionals as the COVID-19 pandemic continues to evolve: “People with heart defects should be encouraged to receive COVID-19 vaccines and boosters and continue to practice additional preventive measures for COVID -19, such as mask-wearing and physical distancing. People with heart defects should also consult with their healthcare teams about additional steps to manage personal risks from COVID-19, given the significantly increased risk of serious infection and serious complications.

Downing noted that not all patients with heart defects who have been hospitalized with COVID-19 have had poor outcomes. “Further work is needed to identify why the clinical course of COVID-19 disease results in significantly worse outcomes for some hospitalized patients with critical COVID-19 disease risk factors, such as heart defects, and not for others. others,” she said.

There are several limitations to this study. Only people previously hospitalized with COVID-19 were included, clinical details about the underlying heart defect were not available, and laboratory tests to identify and/or confirm diagnoses of COVID-19 may vary by country. hospital. Finally, COVID-19 vaccination status was not taken into account, since the vaccines became available in the United States from December 2020.

Co-authors are Regina Simeone, Ph.D.; Matthew Oster, MD, MPH; and Sherry Farr, Ph.D. Author disclosures are listed in the manuscript.