Heart Defects can Raise Differences in COVID-19 Severity

People with heart defects who contracted COVID-19 were more likely to require treatment in the intensive care unit (ICU) or need a ventilator.

People with a congenital heart defect who were hospitalized with COVID-19 infection were at higher risk for severe illness or death than those without a heart defect, according to new research published today in the American Heart Association’s flagship, peer-reviewed journal Circulation.

Congenital heart defects occur when the heart or blood vessels near the heart don’t develop normally before birth.

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‘Among hospitalized COVID-19 patients, 421 or 0.2% had a congenital heart defect.’

According to the American Heart Association’s Heart Disease and Stroke Statistics, congenital heart defects are the most common birth defect worldwide with a global prevalence of 157 per 100,000 in 2017.

“Data comparing COVID-19 outcomes among individuals with and without congenital heart defects has been limited,” said lead author Karrie Downing, M.P.H., an epidemiologist at the National Center on Birth Defects and Developmental Disabilities.

Researchers examined data on hospitalized COVID-19 patients from March 2020 to January 2021, collected in the Premier Healthcare Database Special COVID-19 Release, a database representing approximately 20% of all U.S. hospitalizations.

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The COVID-19 patients with and without heart defects in this study received care in the same hospitals. Differences in age, gender, race/ethnicity, health insurance types, and other high-risk conditions (specifically heart failure, pulmonary hypertension, Down syndrome, diabetes, and obesity) were accounted for across those populations.

During this period, the database had more than 235,000 patients, ages 1 to 64 years old, who were hospitalized for COVID-19. Patients were divided into two groups: those who had a congenital heart defect and those who did not.

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Across these two categories, researchers then determined how many required admission to the ICU, needed a ventilator to help with breathing, or died. Researchers also reviewed other characteristics including other health conditions.

The analysis found that 54% of patients with a congenital heart defect were admitted to the ICU compared to 43% of those without a congenital heart defect.

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In addition, people with congenital heart defects consistently remained at high risk for severe COVID-19 illness, even when divided into categories by age or other health conditions noted in the study, according to the researchers.

These findings show that 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.

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.

More work is also 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.

There are several limitations to this study. Only people already hospitalized with COVID-19 were included, the clinical details about the underlying heart defect were not available, and lab testing to identify and/or confirm COVID-19 diagnoses may vary by hospital.

Lastly, COVID-19 vaccination status was not considered, since the vaccines became available in the U.S. starting in December 2020.

Source-Medindia