Resilience and response of the congenital cardiac network in Italy during the COVID-19 pandemic

Formigari, Roberto; Marcora, Simona; Luciani, Giovanni Battista; Favilli, Silvia; Assenza, Gabriele Egidy; Rinelli, Gabriele; Meliota, Giovanni; Castaldi, Biagio; Limongelli, Giuseppe; Flocco, Serena Francesca; Vairo, Ugo

doi:10.2459/jcm.0000000000001063

Cited by 8 publications

(9 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite limited data, recommendations based on sensible assumptions from what is known about the CHD community of patients have been published ( 10 , 11 ). Only 2 previous publications addressed COVID-19 in the CHD population from areas with high early incidence.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 in Adults With Congenital Heart Disease

Broberg

Kovacs

Sadeghi

et al. 2021

Journal of the American College of Cardiology

View full text Add to dashboard Cite

Background Adults with congenital heart disease (CHD) have been considered potentially high risk for novel coronavirus disease-19 (COVID-19) mortality or other complications. Objectives This study sought to define the impact of COVID-19 in adults with CHD and to identify risk factors associated with adverse outcomes. Methods Adults (age 18 years or older) with CHD and with confirmed or clinically suspected COVID-19 were included from CHD centers worldwide. Data collection included anatomic diagnosis and subsequent interventions, comorbidities, medications, echocardiographic findings, presenting symptoms, course of illness, and outcomes. Predictors of death or severe infection were determined. Results From 58 adult CHD centers, the study included 1,044 infected patients (age: 35.1 ± 13.0 years; range 18 to 86 years; 51% women), 87% of whom had laboratory-confirmed coronavirus infection. The cohort included 118 (11%) patients with single ventricle and/or Fontan physiology, 87 (8%) patients with cyanosis, and 73 (7%) patients with pulmonary hypertension. There were 24 COVID-related deaths (case/fatality: 2.3%; 95% confidence interval: 1.4% to 3.2%). Factors associated with death included male sex, diabetes, cyanosis, pulmonary hypertension, renal insufficiency, and previous hospital admission for heart failure. Worse physiological stage was associated with mortality (p = 0.001), whereas anatomic complexity or defect group were not. Conclusions COVID-19 mortality in adults with CHD is commensurate with the general population. The most vulnerable patients are those with worse physiological stage, such as cyanosis and pulmonary hypertension, whereas anatomic complexity does not appear to predict infection severity.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In the absence of data, consensus recommendations for COVID-19 and CHD have been made based on sensible suppositions regarding at-risk subtypes, including a proposed risk stratification for COVID-19 complications ( 10 ). Another group outlined the potential viral impact of CHD ( 11 ).…”

mentioning

confidence: 99%

COVID-19 in Adults With Congenital Heart Disease

Broberg

Kovacs

Sadeghi

et al. 2021

Journal of the American College of Cardiology

View full text Add to dashboard Cite

show abstract

“…Several measures should have been adopted to deal with an unprecedented need for healthcare resources allocation to care for COVID-19 patients, putting the healthcare systems under serious stress. Both adult and congenital 80,81 cardiac surgery has, as have most surgical activities, been asked to reduce its own activity, giving priority to emergency and nondeferrable cases. Moreover, the outbreak led to a dramatic change concerning both the profile of patients undergoing cardiac operations and the management of them.…”

Section: Discussionmentioning

confidence: 99%

The day after tomorrow: cardiac surgery and coronavirus disease-2019

Bonalumi

Giambuzzi

Buratto³

et al. 2021

Journal of Cardiovascular Medicine

View full text Add to dashboard Cite

The impact of the coronavirus disease-2019 (COVID-19) pandemic forced the governments worldwide to deal with an unprecedented health crisis. The aim of this review is to summarize what happened to cardiac surgery worldwide during the first wave of this pandemic. A literature search was performed to extrapolate key concepts regarding guidelines and reorganization of cardiac surgery wards during COVID-19. Supporting literature was also included to discuss the hot topics related to COVID-19 and cardiac surgery. Hence, both official documents from national scientific societies and single-or multiple-center experiences during the pandemics are reviewed and discussed. In Italy, the first western country hit by the pandemic, two different models were proposed to cope with the need for ICU/ward beds and to reallocate cardiac surgical services: Hub-and-Spoke system ('Hubs', dedicated to perform urgent and nondeferrable surgery, and 'Spokes', turned into COVID centers) and/or a progressive reduction in surgical activity. Worldwide, several guidelines/consensus statements were published, suggesting how to deal with the outbreak. Two different approaches for stratifying surgical indications were proposed: dynamic, based on the number of hospitalized COVID-19 patients; static, based only on the severity of the cardiovascular disease. Moreover, the importance of personal protective equipment was stressed. Several measures should have been adopted to deal with an unprecedented need for healthcare resources allocation to care for COVID-19 patients, putting the healthcare systems under serious stress. Cardiac surgery has, as have most surgical activities, been asked to reduce its own activity, giving priority to emergency and nondeferrable cases.

show abstract

“…Many tele-health strategies were implemented including devices for remote monitoring and telephone-based follow-up 18 . Telemedicine was successful to identify patients who needed an in-person visit 19–21 and contributed to minimizing the risk of infection spreading within fragile populations, such as patients affected by chronic heart disease 22 . The post-pandemic role of telemedicine has yet to be assessed.…”

Section: Coronavirus Disease 2019 Pandemic and Healthcare Systemmentioning

confidence: 99%