Reduced physical activity during COVID-19 in children with congenital heart disease: A longitudinal analysis

Background COVID-19 was associated with a reduction in physical activity in children with congenital heart disease (CHD) in early 2020. Given the increased cardiovascular risk of this population, optimizing cardiovascular health behaviour is important. The aim of the study is to determine how the ongoing COVID-19 pandemic has impacted longitudinal physical activity measures in children with CHD. Methods As part of a prospective cohort study, children and adolescents aged 9–16 years old with moderate-to-complex CHD were recruited from British Columbia (BC) Children’s Hospital and partnership clinics across BC and the Yukon territory. Daily step counts were measured continuously over 3 years (2018–2021) with Fitbit Charge 2TM. School status during COVID-19 pandemic were assessed with parent- or self-report survey. Results 102, 114, and 93 participants had valid Fitbit data during 2018, 2019, and 2020, respectively. There was a significant reduction in the annual mean step count for 2020 (8225±4328 steps) compared to both 2018 (9416±3770 steps) and 2019 (9533±4114 steps) (p < 0.001). There was a loss of seasonal variation in physical activity and reduced levels of physical activity persisted when most children resumed in-person schooling in September 2020. Conclusions We demonstrated a significant decrease in physical activity and loss of seasonal patterns in children with CHD during 2020. These findings represent a worsening of the cardiovascular risk profile in children with CHD, who are already at increased risk of adverse cardiovascular outcomes. Mitigation strategies are needed to optimize the cardiovascular health status of children with CHD as the pandemic persists.

Surgical stabilization of rib fractures in symptomatic COVID-19: A case report.

Severe chest wall injury following trauma is a significant contributing factor to respiratory failure and need for mechanical ventilation in multiply injured patients. Surgical stabilization of rib fractures (SSRF) is increasingly considered to be advantageous in this population. Surgical stabilization has been shown to improve multiple outcomes including ventilator avoidance, liberation from mechanical ventilation, and diminished pulmonary complications in the trauma population, particularly when performed early. During the coronavirus disease 2019 (COVID-19) pandemic, ventilators have become a scarce resource, and conservative strategies have become a critical component of intensive care. We present a report of the perioperative outcome of SSRF in a geriatric polytrauma patient who initially presented after a mechanical fall and co-existing symptomatic COVID-19.

Reduced Physical Activity During COVID-19 Pandemic in Children With Congenital Heart Disease.

Children with congenital heart disease (CHD) are at risk for both COVID-19 and secondary cardiovascular outcomes. Their increased cardiovascular risk may be mitigated through physical activity, but public health measures implemented for COVID-19 can make physical activity challenging. We objectively measured the impact of the COVID-19 pandemic on physical activity, continuously measured by Fitbit step counts, in children with CHD. Step counts were markedly lower in late March and early April 2020, compared with 2019 and early March 2020. It is vital to understand how precautions for COVID-19 will affect the health of children with CHD, especially if they persist long term.