Article Text
Abstract
Objective As COVID-19 continues to affect the global population, it is crucial to study the impact of the disease in vulnerable populations. This study of a diverse, international cohort aims to provide timely, experiential data on the course of disease in paediatric patients with congenital heart disease (CHD).
Methods Data were collected by capitalising on two pre-existing CHD registries, the International Quality Improvement Collaborative for Congenital Heart Disease: Improving Care in Low- and Middle-Income Countries and the Congenital Cardiac Catheterization Project on Outcomes. 35 participating sites reported data for all patients under 18 years of age with diagnosed CHD and known COVID-19 illness during 2020 identified at their institution. Patients were classified as low, moderate or high risk for moderate or severe COVID-19 illness based on patient anatomy, physiology and genetic syndrome using current published guidelines. Association of risk factors with hospitalisation and intensive care unit (ICU) level care were assessed.
Results The study included 339 COVID-19 cases in paediatric patients with CHD from 35 sites worldwide. Of these cases, 84 patients (25%) required hospitalisation, and 40 (12%) required ICU care. Age <1 year, recent cardiac intervention, anatomical complexity, clinical cardiac status and overall risk were all significantly associated with need for hospitalisation and ICU admission. A multivariable model for ICU admission including clinical cardiac status and recent cardiac intervention produced a c-statistic of 0.86.
Conclusions These observational data suggest risk factors for hospitalisation related to COVID-19 in paediatric CHD include age, lower functional cardiac status and recent cardiac interventions. There is a need for further data to identify factors relevant to the care of patients with CHD who contract COVID-19 illness.
- COVID-19
- Heart Defects, Congenital
- Risk Factors
- Global Health
Data availability statement
Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author, LB, upon reasonable request.
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Data availability statement
Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author, LB, upon reasonable request.
Footnotes
Correction notice This article has been corrected since it was first published to correct affiliation 17.
Contributors MJY drafted the initial manuscript, assisted in study design and collected data. LB assisted in study design, developing data collection tools and provided guidance in drafting the manuscript. KG guided and conducted all statistical analyses. OMB, SPB, BB, LFC, UAC, TD, SF, RCM, MLO’B, EdOP, AP-M, DP, NFS, SS, MS and MAFT all assisted in local data collection and provided critical reviews of the manuscript in the drafting and revision stages. EB assisted in data collection and revision of the manuscript, and site coordination. KJJ guided study design, development of the data collection tool, and provided expert oversight in drafting, revising and finalising the study and manuscript, and serves as the guarantor for this work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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Competing interests None declared.
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