Clinical outcome of COVID-19 in patients with adult congenital heart disease

By Saadia Aslam

Original research from Professor Markus Schwerzmann and his team collected clinical outcome data to help identify risk factors for a complicated course of COVID-19 (defined as: hospitalisation requiring non-invasive or invasive ventilation and/or inotropic support, or a fatal outcome) in patients with adult congenital heart disease. Twenty-five centres from nine different European countries participated in the study and recruited consecutive ACHD patients diagnosed with COVID-19 between 27 March and 6 June 2020.

The results showed that of 105 patients with a mean age of 38±13 years (58% women), 13 had a complicated disease course, of whom 5 died. In univariable analysis, age (OR 1.3, 95% CI 1.1 to 1.7, per 5 years), ≥2 comorbidities (OR 7.1, 95% CI 2.1 to 24.5), body mass index of >25 kg/m2 (OR 7.2, 95% CI 1.9 to 28.3) and cyanotic heart disease (OR 13.2, 95% CI 2.5 to 68.4) were associated with a complicated disease course. In a multivariable logistic regression model, cyanotic heart disease was the most important predictor (OR 60.0, 95% CI 7.6 to 474.0).

In this patient group, general risk factors such as; age, obesity and multiple comorbidities are associated with an increased risk of complicated COVID-19 course. However, cyanotic lesions, including unrepaired cyanotic defects or Eisenmenger syndrome were at particularly high risk.

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Schwerzmann M, Ruperti-Repilado FJ, Baumgartner H, Bouma B, Bouchardy J, Budts W, et al. Clinical outcome of COVID-19 in patients with adult congenital heart disease. Heart. 2021 Mar 8:heartjnl-2020-318467. doi: 10.1136/heartjnl-2020-318467. Epub ahead of print. PMID: 33685931; PMCID: PMC7944416.