Columbia University Study Finds That Individuals With Congenital Heart Disease Have A Low Risk Of Severity From COVID-19 Infection
: Researchers from Columbia University Irving Medical Center-New York in a study involving retrospective analysis have found that individuals born with a heart defect who developed COVID-19 symptoms had a low risk of moderate or severe COVID-19 infection.
The study findings were published in the Journal of the American Heart Association. https://www.ahajournals.org/doi/10.1161/JAHA.120.017580
The study can be considered the largest study of its kind to date and it explored the impact of COVID-19 infection on patients with congenital heart disease (CHD).
The specialty center at Irving Medical Center follows more than 7,000 adult and pediatric patients born with a heart defect. Fifty-three CHD patients (median age 34) with COVID-19 infection were reported at their center between March and July 2020.
Corresponding author Dr Matthew Lewis MD told Thailand Medical News, "At the beginning of the pandemic, many feared that congenital heart disease would be as big a risk factor for COVID-19 as adult-onset cardiovascular disease. However, they are "reassured by the low number of patients treated at their center and the patients' outcomes."
Based on study data, among the 43 adults and 10 children with a congenital heart defect infected with COVID-19, additional characteristics included: 58% had complex congenital anatomy; 15% had a genetic syndrome; 11% had pulmonary hypertension; and 17% had obesity.
Further additional analysis found:
-Significantly, the presence of a concurrent genetic syndrome in all patients and advanced physiologic stage in adult patients were each associated with an increased risk of symptom severity.
-Interestingly five patients had trisomy 21 (an extra chromosome at position 21); four patients had Eisenmenger's syndrome (abnormal blood circulation caused by structural defects in the heart); and two patients had DiGeorge syndrome (a condition caused by the deletion of a segment of chromosome 22). Nearly all patients with trisomy 21 and DiGeorge syndrome had moderate/severe COVID-19 symptoms.
-With regards to outcomes among all 53 patients with CHD: nine patients (17%) had a moderate/severe infection, and three patients (6%) died.
The researchers however noted several limitations to their analysis:
-"Although our sample size is small, these results imply that specific congenital heart lesions may not be sufficient cause alone for severe COVID-19 infection."
-"Though it is possible that our patient population exercised stricter adherence to social distancing given early publicized concerns about cardiac risk, these early results appear reassuring."
-"Interestingly the median age and the frequency of acquired cardiac risk factors were lower in hospitalized patients in our cohort compared to published reports of hospitalized patients from COVID-19 in NYC at large. This may be because the CHD community, at large, is younger than the general populatio
n or because individuals with CHD may have distinct risk factors for severe COVID-19 infection when compared to the general population. It is possible that a cohort of elderly CHD patients might have a different risk profile than the general population."
The study team concluded, "Despite evidence that adult-onset cardiovascular disease is a risk factor for worse outcomes among patients with COVID-19, patients with CHD without concomitant genetic syndrome, and adults who are not at advanced physiological stage, do not appear to be disproportionately impacted."
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