Factors affecting COVID-19 outcomes in patients with congenital heart disease

• Published in: Cardiology in the Young 2021-02, Vol.31 (2), p.329-330
• Main Authors: Ahmad, Aisha, Chiejina, Marcellina B A, Bangi, Shifa
• Format: Article
• Language: English
• Subjects: Age; Anti-inflammatory agents; Cardiovascular disease; Cardiovascular diseases; Complications; Congenital diseases; Coronary artery disease; Coronaviruses; COVID-19; Defects; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); General Cardiology; Heart; Heart Defects, Congenital; Heart diseases; Humans; Infections; Inflammation; Kidney diseases; Letter to the Editor; Nonsteroidal anti-inflammatory drugs; Patients; Race factors; Respiratory tract; Respiratory tract diseases; SARS-CoV-2; Trisomy; Ventricle; Viral diseases
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951120004825

Haiduc et al attempt to summarise the current literature surrounding the effect of congenital heart disease (CHD) on COVID-19 outcomes. 1 We propose further consideration of the following factors: age, type and severity of CHD, and comorbidities. Literature also shows racial disparities in the severity of COVID-19 which may confound the effect of CHD on outcomes. 3 Contrary to this review, there is evidence that individual defects such as single ventricular defects are not sufficient cause alone for worse COVID-19 outcomes. 4 Lewis et al reported that out of 53 CHD patients, there appeared to be no correlation between the complexity of the CHD and the subsequent infection-related cardiac decompensation displayed by the patient. 4 This may explain why patients with similar CHDs experience different disease trajectories. [...]using only the CHD status is not a sufficient indicator for poor outcomes and markers of symptom progression such as raised cardiac troponins upon admission may prove more useful. 5 This is particularly relevant since CHD patients with infection-induced myocardial injury are at a higher risk of complications. 5 Treatment protocols used to manage infections should also be considered amongst the studies included in the review. [...]Non-steroidal anti-inflammatory drugs use in early infection is thought to be controversial due to reports of causing more complications when administered for respiratory tract infections. 6 From the studies included in the review, 24% of the patients had comorbidities with the most frequent being genetic conditions, type 2 diabetes mellitus, and chronic kidney disease. 1 Massin et al demonstrates that a significant proportion of children with CHD have associated non-cardiac comorbidities including genetic conditions, with the most common being trisomy 18.