COVID-19 in adult patients with CHD: a matter of anatomy or comorbidities?

Abstract

Little is know about COVID-19 outcome in specific populations such as Adult congenital heart disease (ACHD) patients. We report three cases of adult patients with similar underlying disease with completely different clinical severity at the time of COVID-19 infection. The patient with the most severe clinical course was obese and diabetic, suggesting that COVID-19 mortality and morbidity in Adult congenital heart disease patients might be independent of anatomic complexity.

Impact of COVID-19 on patients with congenital heart disease

“…We identified 19 papers of which 12 were guidelines, commentary, or opinion and 7 included patient data ( Table 1). We included the 7 papers, [2][3][4][5][6][7][8] which contained actual patient data and this included a variety of case reports, case series, and retrospective reviews. We excluded the 12 papers 9-20 that did not include any patient data and were deemed guidelines, opinion pieces, or a commentary.…”

“…A total of 94 suspected or confirmed cases have been reported in 7 papers. [2][3][4][5][6][7][8] By far, the biggest published series is from Italy 2 with 76 patients included. Amongst the 94 reported cases of CHD and COVID-19 infection, 79 patients (84%) were adults and 15 (16%) were children.…”

“…Specific CHD lesions reported in all other papers. [3][4][5][6][7][8] All other papers combined (n = 18)…”

COVID-19 and congenital heart disease: an insight of pathophysiology and associated risks

“…After the exclusion of duplicates, 12 articles were selected for inclusion into the analysis (Fig 1). [11][12][13][14][15][16][17][18][19][20][21][22] These comprised a total of 143 patients, of which 99 had CHDs. The key information from each article is summarised in Table 2.…”

“…29 Although, Ferrero et al demonstrated how the clinical course of COVID-19 can vary in patients with similar physiology and anatomy. 14 A study outlined the categories of children with CHD that would be at increased risk of severe illness if they acquired a COVID-19 infection. These included patients with a large VSD, "single heart physiology" such as hypoplastic left heart syndrome and tricuspid atresia, and patients who had an upcoming surgical procedure or had already undergone one, including the Fontan procedure.…”