COVID-19 in Adults With Congenital Heart Disease.
J Am Coll Cardiol
; 77(13): 1644-1655, 2021 04 06.
Article
em En
| MEDLINE
| ID: mdl-33795039
ABSTRACT
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cianose
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COVID-19
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Cardiopatias Congênitas
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Procedimentos Cirúrgicos Cardíacos
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Hipertensão Pulmonar
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
J Am Coll Cardiol
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos