ABSTRACT
Background: Cardiovascular diseases have been identified as major risk factors for adverse outcomes in patients with novel coronavirus 2019 disease (COVID-19). Patients with genetic diseases of the heart, including those with hypertrophic cardiomyopathy (HCM), have been warned regarding higher risk of adverse outcomes following COVID-19. No specific data, however, has been reported regarding the actual risk of COVID-19 in adults with HCM. We aimed to evaluate incidence and outcomes of COVID-19 in a cohort of adults with HCM followed at one center. Methods: Adults with phenotypic HCM [n=199, age 57±17 years, 55% men, 22% New York Heart Association class >1, 57% obstructive, 9% septal reduction therapy, 22 % positive family history, 41% selectively genotyped (40% positive for pathogenic mutations in MYBPC3, MYH7, and TNNI3 genes), 24% cardioverter-defibrillator implants, 24% paroxysmal or permanent atrial fibrillation (AF), 7% AF ablation] were retrospectively evaluated. Results: Overall, 14 (7%) were diagnosed with COVID-19 [50% men, age 56±16 years, 57% obstructive HCM, 21 % positive family history, 7% genotype positive]. There was no statistically significant demographic or clinical differences between 14 with and 185 without [56% men, age 58±17 years, 57% obstructive, 22 % positive family history, 17% genotype positive] COVID-19 Among those with COVID-19, 4 (27%) were hospitalized and 1 (7%) died of COVID-19. Compared to those with mild disease, hospitalized patients with COVID-19 were older (age 63±13 vs. 53±16 years), more often men (75% vs. 40%) and more often had a positive family history of HCM (50% vs. 10%) without significant differences in other demographic or clinical features. Only 1 patient (7%) was fully vaccinated prior to COVID-19 and had mild symptoms. Currently, 104 (52%) have received at least one dose of a COVID-19 vaccine and 83 (42%) are fully vaccinated. Conclusions: Although COVID-19 infection rate (7%) in this cohort of patients with HCM was below the rate in the general US population (∼10%), hospitalization rate (27%) and death rate (7%) were above those noted in the nation (6.7% and 1.8%, respectively). The data confirms the notion that patients with HCM may have higher risk for developing COVID-19 related adverse outcomes.