COVID-19 in congenital heart disease (COaCHeD) study
Background COVID-19 has caused significant worldwide morbidity and mortality. Congenital heart disease (CHD) is likely to increase vulnerability and understanding the predictors of adverse outcomes is key to optimising care.Objective Ascertain the impact of COVID-19 on people with CHD and define ris...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-11-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/10/2/e002356.full |
| _version_ | 1797367215541977088 |
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| author | Ashish Chikermane Konstantinos Dimopoulos Michael A Gatzoulis Sonya V Babu-Narayan Zdenka Reinhardt Natali AY Chung Paul F Clift Dirk Wilson Petra Jenkins Rachel Knowles Bernadette Khodaghalian Benjamin Smith Owen Miller Umar Mahmood Heba Nashat Aoife Cleary John M Simpson Clive Lewis Catherine Head Sian Chivers Tara Bharucha Dominic Hares Piers EF Daubeney Caroline B Jones Milos Prica James Anthony Victoria Jowett Antonia Hardiman Frances A Bu'Lock Tristan KW Ramcharan Jennifer Shortland Andrew Tometzki David S Crossland Leila Rittey Olga Panagiotopoulou Muhammad Najih L |
| author_facet | Ashish Chikermane Konstantinos Dimopoulos Michael A Gatzoulis Sonya V Babu-Narayan Zdenka Reinhardt Natali AY Chung Paul F Clift Dirk Wilson Petra Jenkins Rachel Knowles Bernadette Khodaghalian Benjamin Smith Owen Miller Umar Mahmood Heba Nashat Aoife Cleary John M Simpson Clive Lewis Catherine Head Sian Chivers Tara Bharucha Dominic Hares Piers EF Daubeney Caroline B Jones Milos Prica James Anthony Victoria Jowett Antonia Hardiman Frances A Bu'Lock Tristan KW Ramcharan Jennifer Shortland Andrew Tometzki David S Crossland Leila Rittey Olga Panagiotopoulou Muhammad Najih L |
| author_sort | Ashish Chikermane |
| collection | DOAJ |
| description | Background COVID-19 has caused significant worldwide morbidity and mortality. Congenital heart disease (CHD) is likely to increase vulnerability and understanding the predictors of adverse outcomes is key to optimising care.Objective Ascertain the impact of COVID-19 on people with CHD and define risk factors for adverse outcomes.Methods Multicentre UK study undertaken 1 March 2020–30 June 2021 during the COVID-19 pandemic. Data were collected on CHD diagnoses, clinical presentation and outcomes. Multivariable logistic regression with multiple imputation was performed to explore predictors of death and hospitalisation.Results There were 405 reported cases (127 paediatric/278 adult). In children (age <16 years), there were 5 (3.9%) deaths. Adjusted ORs (AORs) for hospitalisation in children were significantly lower with each ascending year of age (OR 0.85, 95% CI 0.75 to 0.96 (p<0.01)). In adults, there were 24 (8.6%) deaths (19 with comorbidities) and 74 (26.6%) hospital admissions. AORs for death in adults were significantly increased with each year of age (OR 1.05, 95% CI 1.01 to 1.10 (p<0.01)) and with pulmonary arterial hypertension (PAH; OR 5.99, 95% CI 1.34 to 26.91 (p=0.02)). AORs for hospitalisation in adults were significantly higher with each additional year of age (OR 1.03, 95% CI 1.00 to 1.05 (p=0.04)), additional comorbidities (OR 3.23, 95% CI 1.31 to 7.97 (p=0.01)) and genetic disease (OR 2.87, 95% CI 1.04 to 7.94 (p=0.04)).Conclusions Children were at low risk of death and hospitalisation secondary to COVID-19 even with severe CHD, but hospital admission rates were higher in younger children, independent of comorbidity. In adults, higher likelihood of death was associated with increasing age and PAH, and of hospitalisation with age, comorbidities and genetic disease. An individualised approach, based on age and comorbidities, should be taken to COVID-19 management in patients with CHD. |
| first_indexed | 2024-03-08T17:14:07Z |
| format | Article |
| id | doaj.art-aa0a267f0ab34f7ea87523ab44afe4f7 |
| institution | Directory Open Access Journal |
| issn | 2053-3624 |
| language | English |
| last_indexed | 2024-03-08T17:14:07Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj.art-aa0a267f0ab34f7ea87523ab44afe4f72024-01-03T16:55:08ZengBMJ Publishing GroupOpen Heart2053-36242023-11-0110210.1136/openhrt-2023-002356COVID-19 in congenital heart disease (COaCHeD) studyAshish Chikermane0Konstantinos Dimopoulos1Michael A Gatzoulis2Sonya V Babu-Narayan3Zdenka Reinhardt4Natali AY Chung5Paul F Clift6Dirk Wilson7Petra Jenkins8Rachel Knowles9Bernadette Khodaghalian10Benjamin Smith11Owen Miller12Umar Mahmood13Heba Nashat14Aoife Cleary15John M Simpson16Clive Lewis17Catherine Head18Sian Chivers19Tara Bharucha20Dominic Hares21Piers EF Daubeney22Caroline B Jones23Milos Prica24James Anthony25Victoria Jowett26Antonia Hardiman27Frances A Bu'Lock28Tristan KW Ramcharan29Jennifer Shortland30Andrew Tometzki31David S Crossland32Leila Rittey33Olga Panagiotopoulou34Muhammad Najih L35Department of Congenital Cardiology, Birmingham Children`s Hospital NHS Foundation Trust, Birmingham, UKDepartment of Adult Congenital heart disease, Royal Brompton & Harefield NHS Foundation Trust, London, UKAdult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, UKDepartment of Congenital Cardiology, Royal Brompton & Harefield NHS Foundation Trust, London, UKDepartment of Cardiopulmonary Transplantation, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UKDepartment of Adult Congenital heart disease, St Thomas` Hospital, London, UKDepartment of Adult Congenital Cardiology, Queen Elizabeth Hospital Birmingham, Birmingham, UKDepartment of Congenital Cardiology, University Hospital of Wales Healthcare NHS Trust, Cardiff, UK1Liverpool Heart and Chest HospitalDepartment of Public Health Medicine, Great Ormond Street Hospital for Children, London, UKDepartment of Congenital Cardiology, Alder Hey Children`s NHS Foundation Trust, Liverpool, UKDepartment of Congenital Cardiology, Royal Hospital for Sick Children Yorkhill, Glasgow, UKDepartment of Congenital Cardiology, Evelina London Children`s Hospital, London, UKDepartment of Congenital Cardiology, Glenfield Hospital East Midlands Congenital Heart Centre, Leicester, UKDepartment of Adult Congenital heart disease, Royal Brompton & Harefield NHS Foundation Trust, London, UKDepartment of Congenital Cardiology, Evelina London Children`s Hospital, London, UKDepartment of Congenital Cardiology, Evelina London Children`s Hospital, London, UKDepartment of Adult Congenital heart disease, Papworth Hospital, Cambridge, UKDepartment of Adult Congenital heart disease, Norfolk and Norwich University Hospital NHS Trust, Norwich, UKDepartment of Congenital Cardiology, Royal Brompton & Harefield NHS Foundation Trust, London, UKDepartment of Congenital Cardiology, Southampton Children`s Hospital, Southampton, UKDepartment of Congenital Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UKDepartment of Congenital Cardiology, Royal Brompton and Harefield NHS Trust, London, UKDepartment of Congenital Cardiology, Alder Hey Children`s NHS Foundation Trust, Liverpool, UKDepartment of Adult Congenital heart disease, Leeds Teaching Hospitals NHS Trust, Leeds, UKDepartment of Adult Congenital heart disease, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UKDepartment of Congenital Cardiology, Great Ormond Street Hospital for Children, London, UKDepartment of Adult Congenital heart disease, Norfolk and Norwich University Hospital NHS Trust, Norwich, UKDepartment of Congenital Cardiology, Glenfield Hospital East Midlands Congenital Heart Centre, Leicester, UKDepartment of Congenital Cardiology, Birmingham Women`s and Children`s NHS Foundation Trust, Birmingham, UKDepartment of Congenital Cardiology, Bristol Royal Hospital for Children, Bristol, UKDepartment of Congenital Cardiology, Bristol Royal Hospital for Children, Bristol, UKDepartment of Congenital Cardiology, Freeman Hospital Cardiothoracic Centre, Newcastle upon Tyne, UKDepartment of Congenital Cardiology, Leeds Children`s Hospital, Leeds, UKDepartment of Congenital Cardiology, Royal Hospital for Sick Children Yorkhill, Glasgow, UKDepartment of Congenital Cardiology, Southampton Children`s Hospital, Southampton, UKBackground COVID-19 has caused significant worldwide morbidity and mortality. Congenital heart disease (CHD) is likely to increase vulnerability and understanding the predictors of adverse outcomes is key to optimising care.Objective Ascertain the impact of COVID-19 on people with CHD and define risk factors for adverse outcomes.Methods Multicentre UK study undertaken 1 March 2020–30 June 2021 during the COVID-19 pandemic. Data were collected on CHD diagnoses, clinical presentation and outcomes. Multivariable logistic regression with multiple imputation was performed to explore predictors of death and hospitalisation.Results There were 405 reported cases (127 paediatric/278 adult). In children (age <16 years), there were 5 (3.9%) deaths. Adjusted ORs (AORs) for hospitalisation in children were significantly lower with each ascending year of age (OR 0.85, 95% CI 0.75 to 0.96 (p<0.01)). In adults, there were 24 (8.6%) deaths (19 with comorbidities) and 74 (26.6%) hospital admissions. AORs for death in adults were significantly increased with each year of age (OR 1.05, 95% CI 1.01 to 1.10 (p<0.01)) and with pulmonary arterial hypertension (PAH; OR 5.99, 95% CI 1.34 to 26.91 (p=0.02)). AORs for hospitalisation in adults were significantly higher with each additional year of age (OR 1.03, 95% CI 1.00 to 1.05 (p=0.04)), additional comorbidities (OR 3.23, 95% CI 1.31 to 7.97 (p=0.01)) and genetic disease (OR 2.87, 95% CI 1.04 to 7.94 (p=0.04)).Conclusions Children were at low risk of death and hospitalisation secondary to COVID-19 even with severe CHD, but hospital admission rates were higher in younger children, independent of comorbidity. In adults, higher likelihood of death was associated with increasing age and PAH, and of hospitalisation with age, comorbidities and genetic disease. An individualised approach, based on age and comorbidities, should be taken to COVID-19 management in patients with CHD.https://openheart.bmj.com/content/10/2/e002356.full |
| spellingShingle | Ashish Chikermane Konstantinos Dimopoulos Michael A Gatzoulis Sonya V Babu-Narayan Zdenka Reinhardt Natali AY Chung Paul F Clift Dirk Wilson Petra Jenkins Rachel Knowles Bernadette Khodaghalian Benjamin Smith Owen Miller Umar Mahmood Heba Nashat Aoife Cleary John M Simpson Clive Lewis Catherine Head Sian Chivers Tara Bharucha Dominic Hares Piers EF Daubeney Caroline B Jones Milos Prica James Anthony Victoria Jowett Antonia Hardiman Frances A Bu'Lock Tristan KW Ramcharan Jennifer Shortland Andrew Tometzki David S Crossland Leila Rittey Olga Panagiotopoulou Muhammad Najih L COVID-19 in congenital heart disease (COaCHeD) study Open Heart |
| title | COVID-19 in congenital heart disease (COaCHeD) study |
| title_full | COVID-19 in congenital heart disease (COaCHeD) study |
| title_fullStr | COVID-19 in congenital heart disease (COaCHeD) study |
| title_full_unstemmed | COVID-19 in congenital heart disease (COaCHeD) study |
| title_short | COVID-19 in congenital heart disease (COaCHeD) study |
| title_sort | covid 19 in congenital heart disease coached study |
| url | https://openheart.bmj.com/content/10/2/e002356.full |
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