Impact of the COVID-19 pandemic on CHD care and emotional wellbeing

Abstract

Background: Understanding the impact of the COVID-19 pandemic on paediatric non-COVID-19-related care, as well as patient and caregiver concerns and stressors, is critical for informing healthcare delivery. It was hypothesised that high care disruptions and psychological stress would be observed among paediatric and adult CHD patients in the early phase of the pandemic. Methods: A cross-sectional, international, electronic survey study was completed. Eligible participants included parents of children with acquired or CHD, adults with CHD, or caregivers of adults with CHD. Results: A total of 1220 participants from 25 countries completed the survey from 16 April to 4 May, 2020. Cardiac care disruption was significant with 38% reporting delays in pre-pandemic scheduled cardiac surgeries and 46% experiencing postponed cardiac clinic visits. The majority of respondents (75%) endorsed moderate to high concern about the patient with heart disease becoming ill from COVID-19. Worry about returning for in-person care was significantly greater than worry of harm to patient due to postponed care. Clinically significant psychological stress was high across the sample including children (50%), adults with CHD (42%), and caregivers (42%). Conclusions: The early phase of the COVID-19 pandemic contributed to considerable disruptions in cardiac care for patients with paediatric and adult CHD. COVID-19-related fears are notable with potential to impact willingness to return to in-person care. Psychological stress is also very high necessitating intervention. Further study of the impact of delays in care on clinical outcomes is warranted.

What was the impact of the first wave of COVID-19 on the delivery of care to children and adults with congenital heart disease? A qualitative study using online forums

“…The impact of COVID-19 on the delivery of services to patients with CHD in the UK has been significant, with Open access consequences for both patients and their parents/carers in terms of anxiety and stress. Our findings support those of Cousino and colleagues, 12 who also identified high levels of disruption to routine CHD services and resulting effects on mental health, although, in contrast to this latter study, we did not find a high level of concern expressed about returning to face-to-face appointments. On the contrary, many respondents in our study wanted face-to-face appointments to be reinstated.…”

“…10 11 But, as with other patient groups, services for patients with CHD have seen significant and abrupt changes since March 2020. In an international survey, patients with CHD and parents/ carers reported significant disruption to scheduled cardiac surgery and clinic visits and high levels of psychological stress as a result of the pandemic, 12 supporting findings with other patient cohorts. [13][14][15][16][17] However, how and who communicates with patients with CHD and/ or their carers in relation to COVID-19 has not been explored nor how patients/carers think services should be delivered in the event of a future wave of COVID-19 infection.…”

Impact of COVID-19 on Families of Pediatric Solid Organ Transplant Recipients

“…Moreover, in our clinical practice, we have observed that some parents of pediatric transplant recipients have asked medical teams for documentation demonstrating their children’s health status in order to limit their own exposure in their work environment. This extra effort to protect themselves is probably due to their fear, in some cases, of working in the medical field in the COVID-19 context ( Menon et al, 2020 ) and, more specifically, to their fear of infecting their child, who they perceive as potentially more vulnerable than the general population ( Cousino et al, 2020 , Zhao et al, 2020 ).…”

“…Not disregarding some minor but positive effects from the pandemic ( Gambin et al, 2020 ) and in line with the psychosocial opportunities pointed out by Serlachius et al (2020) regarding youth with chronic health conditions, most families in both groups reported that the pandemic has allowed them to spend and enjoy more time together and feel more united and cohesive as a family during the lockdown. A study by Cousino et al (2020) found a significant psychological impact of COVID-19 in all family members of pediatric SOT recipients. In our study, we found similar results but, although a larger psychological impact was expected in the SOT group, no differences were found between the groups.…”

“…In addition, the reported results reflect a precise moment in the pandemic; results may change over time as we get more knowledge about COVID-19 ( Menon et al, 2020 ) or as new scenarios emerge ( Downes et al, 2020 ). Results could also be expected to differ between countries or regions ( Cousino et al, 2020 ), possibly due to differences in the mitigation measures taken, but more studies are needed. A next step for this line of research would be to conduct a follow-up evaluation on the impact, functioning, and coping strategies used by families of SOT recipients in the face of more sustained pandemic-related stress.…”