Outcome of COVID-19-positive children with heart disease and grown-ups with congenital heart disease: A multicentric study from India

Sachdeva, Sakshi; Ramakrishnan, Sivasubramanian; Choubey, Mrigank; Koneti, Nageswara Rao; Kalaivani, Mani; Bakhru, Shweta; Gupta, Saurabh Kumar; Gangopadhyay, Debasree; Kasturi, Soumya; Jayashree, Muralidharan; Nayak, Hemant Kumar; Sivakumar, Kothandam; Bobhate, Prashant; Awasthy, Neeraj; Das, Debasis; Chakrabarti, Manisha; Muthukumaran, Chinnaswamy Sivaprakasam; Rajan, Sudarsan; Dhulipudi, Bhargavi; Chaudhary, Shilpi; Mahimarangaiah, Jayaranganath; Saxena, Anitá; Iyer, Krishna Subramony; Kumar, Raman; Kothari, Shyam Sunder; Kulkarni, Snehal; Rao, Suresh

doi:10.4103/apc.apc_134_21

Cited by 27 publications

(16 citation statements)

References 34 publications

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“…These data included 686 children negative (mortality 15.8%) and 19 children positive (mortality 12.4%) for coronavirus disease 2019 undergoing surgery, comprising predominantly Risk adjustment for congenital heart surgery score category 2 patients (50%). 22 Post-operative mortality observed across 24 congenital heart surgery from India reveals a doubled mortality rate in comparison to historic times (9.1% versus 4.3%). 2 These are preliminary data emerging from the Indian sub-continent serving a contemporary basis for risk stratification of congenital heart surgery during the pandemic.…”

Section: Discussionmentioning

confidence: 97%

Coronavirus disease 2019 convalescent children: outcomes after congenital heart surgery

et al. 2021

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Background – Children with exposure to COVID-19 in recent times (asymptomatic or symptomatic infection) approaching congenital heart surgery (CHS) program are in increasing numbers. Understanding outcomes of such children will help risk-stratify and guide optimization prior to CHS. Objective: The objective of the present study was to determine whether convalescent COVID-19 children undergoing congenital heart surgery have any worse mortality or postoperative outcomes. Design: Consecutive children undergoing CHS from Oct 2020 to May 2021 were enrolled after testing for RT-PCR (Reverse Transcriptase Polymerase chain test) or rapid antigen test (RAT) and IgG antibody prior to surgery. Convalescent COVID-19 was defined in any asymptomatic patient positive for IgG antibodies and negative for RT-PCR or RAT anytime 6 weeks prior to surgery. Control patients were negative for any of the three tests. Mortality and postoperative outcomes were compared among the groups. Results: 1129 consecutive CHS were stratified as convalescence and control. COVID-19 Convalescent (n=349) and COVID-19 control (n=780) groups were comparable for all demographic and clinical factors except younger and smaller kids in control. Convalescent children had no higher mortality, ventilation duration, ICU and hospital stay, no higher support with ECMO, HFNC, no higher need for re-intubations, re-admissions, and no higher infections as CLABSI, SSI, and VAP on comparison with COVID-19 control children. Conclusions: Convalescent COVID-19 do not have any unfavorable outcomes as compared to COVID-19 control children. Positive IgG antibody screening prior to surgery is suggestive of convalescence and supports comparable outcomes on par with control peers.

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Section: Discussionmentioning

confidence: 97%

Coronavirus disease 2019 convalescent children: outcomes after congenital heart surgery

et al. 2021

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“…In addition, it was found that in-hospital mortality of CHD patients that were COVID-19 positive was much higher than those that were not (27.1% vs 9.1%), highlighting the fact that COVID-19 infection can be quite dangerous in these patients and that the high mortality rate cannot be explained by their pre-existing condition alone. The mortality rate was greater in cyanotic versus acyanotic CHD patients, though the difference was not significant [ 68 ]. However, in a study conducted on adults with CHD, it was found that cyanotic heart disease (versus acyanotic) was the most important predicting factor for COVID-19 complications [ 69 ].…”

Section: Resultsmentioning

confidence: 99%

COVID-19 Vaccines in the Pediatric Population: A Focus on Cardiac Patients

Lababidi,

Bitar

et al. 2024

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Due to the deleterious global impact of the COVID-19 pandemic, tremendous effort has been invested in the development of vaccines against the virus. Vaccine candidates are first tested in adult populations, a number of which have been approved for EUL by the WHO, and are in use across the USA and MENA region. The question remains whether these (or other) vaccines should be recommended to a neonatal, pediatric, and/or adolescent cohort. Incidence and severity of COVID-19 infection are low in pediatric, neonatal, and adolescent patients. Since both overall incidence and severity are lower in children than in adults, safety is an important consideration in vaccine approval for these age groups, in addition to efficacy and a decreased risk of transmission. The following review discusses vaccine immunology in children aged 0–18 years, with emphasis on the negative impact of the COVID-19 pandemic on the lives of children, considerations for pediatric vaccine approval, and available vaccines for pediatric cohorts along with a breakdown of the efficacy, advantages, and disadvantages for each. This review also contains current and future perspectives, as well as a section on the cardiovascular implications and related dynamics of pediatric COVID-19 vaccination.

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“…Although the adjusted risk of mortality in CHD was 1.7 times higher, the association was not statistically significant likely due to lack of power(95% CI 0.6–5.3), P = 0.32. Reports with a smaller number of children with CHD have reported a higher percentage of death in children with CHD and COVID-19 infection [ 31 , 32 ]. In a study of 160 children with CHD hospitalized with COVID-19, Strah et al reported a mortality rate in children with COVID-19 of 3.8% vs. 0.8% in the non-CHD group.…”

Section: Discussionmentioning

confidence: 99%

Impact of congenital heart disease on outcomes among pediatric patients hospitalized for COVID-19 infection

et al. 2023

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Background COVID-19 infection is generally regarded as an acute self-limiting illness in children, but it can cause significant morbidity and mortality in both healthy and high-risk children. There are limited data on the outcomes of children with congenital heart disease (CHD) and COVID-19. This study aimed to examine the risks of mortality, in-hospital cardiovascular and non-cardiovascular complications in this patient population. Methods We analyzed data from hospitalized pediatric patients from 2020 using the nationally representative National Inpatient Sample (NIS). Children hospitalized for COVID-19 were included, and weighted data were used to compare in-hospital mortality and morbidities between children with and without CHD. Results Out of 36,690 children admitted with a diagnosis of COVID-19 infection(ICD-10 code:U07.1 and B97.29) during calendar year 2020, 1240 (3.4%) had CHD. The risk of mortality in children with CHD was not significantly higher than those without CHD(1.2% vs. 0.8%, p = 0.50), with adjusted OR (aOR) of 1.7 (95% CI: 0.6–5.3). Tachyarrhythmias and heart block were more likely in CHD children with an aOR of 4.2 (95% CI: 1.8–9.9) and aOR of 5.0 (95% CI: 2.4–10.8), respectively. Similarly, respiratory failure [aOR = 2.0 (1.5–2.8)], respiratory failure requiring non-invasive mechanical ventilation [aOR = 2.7 (1.4–5.2)] and invasive mechanical ventilation [aOR = 2.6 (1.6-4.0)], and acute kidney injury [aOR = 3.4 (2.2–5.4)] were all significantly higher among patients with CHD. Median length of hospital stay in children with CHD was longer than those without CHD [5 days (IQR: 2–11) vs. 3 days (IQR: 2–5), p = < 0.001]. Conclusions Children with CHD hospitalized with COVID-19 infection were at increased risk of serious cardiovascular and non-cardiovascular adverse clinical outcomes. They also had increased length of hospital stay and utilization of healthcare resources.

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Outcome of COVID-19-positive children with heart disease and grown-ups with congenital heart disease: A multicentric study from India

Cited by 27 publications

References 34 publications

Coronavirus disease 2019 convalescent children: outcomes after congenital heart surgery

Coronavirus disease 2019 convalescent children: outcomes after congenital heart surgery

COVID-19 Vaccines in the Pediatric Population: A Focus on Cardiac Patients

Impact of congenital heart disease on outcomes among pediatric patients hospitalized for COVID-19 infection

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