Adults with congenital heart disease may be at elevated risk for complicated COVID-19
Patients with adult congenital heart disease who have general risk factors such as age, obesity and multiple comorbidities had elevated risk for complicated COVID-19, according to researchers.
Cyanotic lesions, such as unrepaired cyanotic defects or Eisenmenger syndrome, were among the congenital cardiac defects that put patients at particularly high risk, the researchers wrote.
“So far, COVID-19 risk stratification in patients with adult congenital heart disease was based on expert opinion. Our cohort study provides observational evidence regarding COVID-19 risk factors in patients with adult congenital heart disease and improves tailoring of recommendations for preventive measures in individual patients,” Markus Schwerzmann, MD, clinician scientist at the Center for Congenital Heart Disease, Inselspital University Hospital in Bern, Switzerland, and colleagues wrote.
The researchers analyzed a cohort of 105 patients (mean age, 38 years; 58% women), of whom 13 had a complicated disease course and five died.
According to the researchers, 74% of patients had a confirmed diagnosis of COVID-19 determined by testing vs. 26% who had a diagnosis based on clinical grounds.
In univariable-adjusted models, researchers reported that age (OR = 1.3; 95% CI, 1.1-1.7, per 5 years), at least two comorbidities (OR = 7.1; 95% CI, 2.1-24.5), BMI greater than 25 kg/m2 (OR = 7.2; 95% CI, 1.9-28.3) and cyanotic heart disease (OR = 13.2; 95% CI, 2.5-68.4) were linked to a complicated disease course.
In a multivariable logistic regression model, the most significant predictor of complicated COVID-19 was cyanotic heart disease (OR = 60; 95% CI, 7.6-474).
“These data can be used to identify patients with adult congenital heart disease more vulnerable for a complicated COVID-19 course. Given the paucity of data so far, further confirmation of our findings is needed,” the researchers wrote.