Jolanda Sabatino1, Paolo Ferrero2, Massimo Chessa3, Francesco Bianco4, Paolo Ciliberti5, Aurelio Secinaro6, Lilia Oreto7, Martina Avesani8, Valentina Bucciarelli4, Giuseppe Calcaterra9, Maria Pia Calabrò10, Maria Giovanna Russo11, Pier Paolo Bassareo12, Paolo Guccione5, Ciro Indolfi1, Giovanni Di Salvo8. 1. Department of Medical and Surgical Sciences, "Magna Graecia" University, 88100 Catanzaro, Italy. 2. Pediatric cardiology and ACHD, Cardiovascular Department, ASST Papa Giovanni 23, 24127 Bergamo, Italy. 3. ACHD UNIT-Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato, 20097 Milan, Italy. 4. Pediatric and Congenital Cardiology Unit, Azienda Ospedaliero Universitaria Ancona, 60126 Ancona, Italy. 5. Pediatric Cardiology and Cardiac Surgery Department, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy. 6. Department of Imaging, Advanced Cardiovascular Imaging Unit, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy. 7. Mediterranean Pediatric Cardiology Center, Bambino Gesù Pediatric Hospital, 98039 Taormina (ME), Italy. 8. Department of Women's and Children's Health, University of Padua, 35122 Padua, Italy. 9. Department of Cardiology, University of Palermo, 90133 Palermo, Italy. 10. Department of Human Pathology of Adulthood and Childhood, University of Messina, 98125 Messina, Italy. 11. Department of Cardiology, Luigi Vanvitelli University of Naples, Monaldi Hospital, 80131 Naples, Italy. 12. University College of Dublin, Mater Misericordiae University Hospital, Dublin 4, Ireland.
Abstract
BACKGROUND: The pandemic of Novel Coronavirus Disease 2019 (COVID-19) is challenging, given the large number of hospitalized patients. Cardiovascular co-morbidities are linked to a higher mortality risk. Thus, patients with Congenital Heart Disease (CHD) might represent a high-risk population. Nevertheless, no data about them are available, yet. Hence, we conducted a nationwide survey to assess clinical characteristics and outcomes in patients with congenital heart disease affected by COVID-19. METHODS AND RESULTS: This is a multi-centre, observational, nationwide survey, involving high-volume Italian CHD centres. COVID-19 diagnosis was defined as either "clinically suspected" or "confirmed", where a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) test had been performed and was positive. Cardiovascular comorbidities were observed among adult patients-atrial fibrillation (seven; 9%), hypertension (five; 7%), obesity (seven; 9%) and diabetes (one; 1%)-but were absent among children. Cardiovascular complications were mainly observed in the "confirmed" COVID-19+ group, consisting of heart failure (9%), palpitations/arrhythmias (3%), stroke/TIA (3%) and pulmonary hypertension (3%). Cardiovascular symptoms such as chest pain (1%), myocardial injury (1%) and pericardial effusion (1%) were also recorded. On the contrary, CHD patients from the clinically suspected COVID-19 group presented no severe symptoms or complications. CONCLUSIONS: Despite previous reports pointing to a higher case-fatality rate among patients with cardiovascular co-morbidities, we observed a mild COVID-19 clinical course in our cohort of CHD patients. Although these results should be confirmed in larger cohorts to investigate the underlying mechanisms, the findings of low cardiovascular complications rates and no deaths are reassuring for CHD patients.
BACKGROUND: The pandemic of Novel Coronavirus Disease 2019 (COVID-19) is challenging, given the large number of hospitalized patients. Cardiovascular co-morbidities are linked to a higher mortality risk. Thus, patients with Congenital Heart Disease (CHD) might represent a high-risk population. Nevertheless, no data about them are available, yet. Hence, we conducted a nationwide survey to assess clinical characteristics and outcomes in patients with congenital heart disease affected by COVID-19. METHODS AND RESULTS: This is a multi-centre, observational, nationwide survey, involving high-volume Italian CHD centres. COVID-19 diagnosis was defined as either "clinically suspected" or "confirmed", where a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) test had been performed and was positive. Cardiovascular comorbidities were observed among adult patients-atrial fibrillation (seven; 9%), hypertension (five; 7%), obesity (seven; 9%) and diabetes (one; 1%)-but were absent among children. Cardiovascular complications were mainly observed in the "confirmed" COVID-19+ group, consisting of heart failure (9%), palpitations/arrhythmias (3%), stroke/TIA (3%) and pulmonary hypertension (3%). Cardiovascular symptoms such as chest pain (1%), myocardial injury (1%) and pericardial effusion (1%) were also recorded. On the contrary, CHD patients from the clinically suspected COVID-19 group presented no severe symptoms or complications. CONCLUSIONS: Despite previous reports pointing to a higher case-fatality rate among patients with cardiovascular co-morbidities, we observed a mild COVID-19 clinical course in our cohort of CHD patients. Although these results should be confirmed in larger cohorts to investigate the underlying mechanisms, the findings of low cardiovascular complications rates and no deaths are reassuring for CHD patients.
Authors: Jolanda Sabatino; Giovanni Di Salvo; Giuseppe Calcaterra; Pier Paolo Bassareo; Lilia Oreto; Ilaria Cazzoli; Maria Pia Calabrò; Paolo Guccione; Michael A Gatzoulis Journal: Int J Cardiol Congenit Heart Dis Date: 2021-06-16
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