COVID-19 international experience in paediatric patients with congenital heart disease

Abstract

ObjectiveAs COVID-19 continues to affect the global population, it is crucial to study the impact of the disease in vulnerable populations. This study of a diverse, international cohort aims to provide timely, experiential data on the course of disease in paediatric patients with congenital heart disease (CHD).MethodsData were collected by capitalising on two pre-existing CHD registries, the International Quality Improvement Collaborative for Congenital Heart Disease:Improving Care in Low- and Middle-Income Countriesand the Congenital Cardiac Catheterization Project on Outcomes. 35 participating sites reported data for all patients under 18 years of age with diagnosed CHD and known COVID-19 illness during 2020 identified at their institution. Patients were classified as low, moderate or high risk for moderate or severe COVID-19 illness based on patient anatomy, physiology and genetic syndrome using current published guidelines. Association of risk factors with hospitalisation and intensive care unit (ICU) level care were assessed.ResultsThe study included 339 COVID-19 cases in paediatric patients with CHD from 35 sites worldwide. Of these cases, 84 patients (25%) required hospitalisation, and 40 (12%) required ICU care. Age <1 year, recent cardiac intervention, anatomical complexity, clinical cardiac status and overall risk were all significantly associated with need for hospitalisation and ICU admission. A multivariable model for ICU admission including clinical cardiac status and recent cardiac intervention produced a c-statistic of 0.86.ConclusionsThese observational data suggest risk factors for hospitalisation related to COVID-19 in paediatric CHD include age, lower functional cardiac status and recent cardiac interventions. There is a need for further data to identify factors relevant to the care of patients with CHD who contract COVID-19 illness.

Risk Factors for Pediatric Critical COVID-19: A Systematic Review and Meta-Analysis

“…For instance, there is evidence to suggest that diabetic children who maintain good glycemic control are at no greater risk than the general population [40, 78, 155, 156]. Similarly, children with congenital heart disease who have undergone surgical repair or no longer have a hemodynamically significant abnormality may be at lower risk [35, 157].…”

COVID-19 and heart disease in children: What have we learned?

“…[ 13 ] However, many studies suggested a higher risk of morbidity among children with COVID-19 admitted to hospitals. [ 14 15 ] A large analysis of 339 cardiac patients from 35 international centers, who had a recent COVID illness[ 16 ] reported a 25% hospitalization rate and 15% of children required ICU care. The study reported an overall mortality of 5%, mostly from the non-US centers.…”

“…The study reported an overall mortality of 5%, mostly from the non-US centers. [ 16 ] A large retrospective study from India,[ 12 ] which included 94 hospitalized patients, however, reported a high mortality rate (13.8%). The study is one of the largest and represents real-time, cross-sectional practice across India.…”

SARS-COV-2 Infection in Children and Young People in Bulgaria – A Prospective, Single-Center, Cohort Study

“…The condition was fi rst described in May 2020 in UK, with evidence of a hyperinfl ammatory condition similar to Kawasaki disease [9]. These children presented with respiratory failure, cardiovascular insuffi ciency, or liver involvement [10][11][12]. The condition was termed multisystem infl ammatory syndrome in children (MIS-C) and adolescents temporarily related to COVID-19.…”