Congenital heart disease increases risk of poor COVID-19 outcomes, including death
Hospitalized COVID-19 patients with a history of congenital heart disease (CHD) face a much higher risk of severe illness or death, according to new research published in Circulation.[1]
The study’s authors noted that prior studies in this area have lacked important context.
“Most publications on congenital heart defects and COVID-19 illness have been restricted to patients at congenital cardiology centers, limiting generalizability, because many individuals with CHD do not receive specialized cardiology care,” wrote first author Karrie F. Downing, MPH, an epidemiologist with the CDC’s COVID-19 Response Team, and colleagues. “Furthermore, the studies did not include comparison groups without CHD or adjust for differences in established risk factors for critical COVID-19, and comparisons to general population estimates may be confounded.”
Downing et al. examined information from more than 235,000 hospitalized COVID-19 patients who received care in the United States from March 2020 to January 2020. All data came from the Premier Healthcare Database Special COVID-19 Release, a database designed to represent approximately 20% of all hospitalizations in the United States.
Overall, 0.2% of patients presented with a history of CHD. Among that cohort, 61% of patients were men, and 73% were over the age of 30. In addition, 55% of patients were non-Hispanic white, 19% were Hispanic and 16% were non-Hispanic black.
CHD patients, the team found, were more likely to present with at least one other heart condition (68% vs. 59%). They also faced a higher risk of being admitted to the ICU (54% vs. 43%), requiring a ventilator to breathe (24% vs. 15%) and dying while hospitalized (11% vs. 7%).
These risks, the group added, still remained when patients were categorized specifically by age or other health conditions.
“People with heart defects should be encouraged to receive the COVID-19 vaccines and boosters and to continue to practice additional preventive measures for COVID-19, such as mask-wearing and physical distancing,” Downing said in a prepared statement. “People with heart defects should also consult with their health care teams about additional steps to manage personal risks related to COVID-19, given the significantly increased risk of severe infection and serious complications.”
The team’s analysis did have certain limitations. Only hospitalized patients were evaluated, for instance, and the lab testing that confirmed COVID-19 diagnoses was not consistent from one health system to the next. Also, vaccination status was not a focus, because vaccines were only made available to the public near the end of the trial.
Downing also noted that more research is still needed “to identify why the clinical course of COVID-19 disease results in significantly worse outcomes for some hospitalized patients with risk factors for critical COVID-19 illness, like heart defects, and not for others.”
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Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.