Subject(s)
Cyanosis , Pandemics , Cyanosis/diagnosis , Cyanosis/epidemiology , Cyanosis/etiology , Humans , Mass Screening , Oximetry , OxygenABSTRACT
BACKGROUND: Adults with congenital heart disease (CHD) have been considered potentially high risk for novel coronavirus disease-19 (COVID-19) mortality or other complications. OBJECTIVES: This study sought to define the impact of COVID-19 in adults with CHD and to identify risk factors associated with adverse outcomes. METHODS: Adults (age 18 years or older) with CHD and with confirmed or clinically suspected COVID-19 were included from CHD centers worldwide. Data collection included anatomic diagnosis and subsequent interventions, comorbidities, medications, echocardiographic findings, presenting symptoms, course of illness, and outcomes. Predictors of death or severe infection were determined. RESULTS: From 58 adult CHD centers, the study included 1,044 infected patients (age: 35.1 ± 13.0 years; range 18 to 86 years; 51% women), 87% of whom had laboratory-confirmed coronavirus infection. The cohort included 118 (11%) patients with single ventricle and/or Fontan physiology, 87 (8%) patients with cyanosis, and 73 (7%) patients with pulmonary hypertension. There were 24 COVID-related deaths (case/fatality: 2.3%; 95% confidence interval: 1.4% to 3.2%). Factors associated with death included male sex, diabetes, cyanosis, pulmonary hypertension, renal insufficiency, and previous hospital admission for heart failure. Worse physiological stage was associated with mortality (p = 0.001), whereas anatomic complexity or defect group were not. CONCLUSIONS: COVID-19 mortality in adults with CHD is commensurate with the general population. The most vulnerable patients are those with worse physiological stage, such as cyanosis and pulmonary hypertension, whereas anatomic complexity does not appear to predict infection severity.
Subject(s)
COVID-19 , Cardiac Surgical Procedures , Cyanosis , Heart Defects, Congenital , Hypertension, Pulmonary , Adult , COVID-19/mortality , COVID-19/therapy , COVID-19 Testing/methods , Cardiac Surgical Procedures/methods , Cardiac Surgical Procedures/statistics & numerical data , Causality , Comorbidity , Cyanosis/diagnosis , Cyanosis/etiology , Cyanosis/mortality , Female , Global Health/statistics & numerical data , Heart Defects, Congenital/classification , Heart Defects, Congenital/epidemiology , Heart Defects, Congenital/physiopathology , Heart Defects, Congenital/therapy , Hospitalization/statistics & numerical data , Humans , Hypertension, Pulmonary/diagnosis , Hypertension, Pulmonary/etiology , Hypertension, Pulmonary/mortality , Male , Mortality , Patient Acuity , Risk Factors , SARS-CoV-2/isolation & purification , Symptom AssessmentABSTRACT
The incidence of novel coronavirus disease-19 (nCoV-19) and its associated complications is higher in high-risk groups. In this article, we explain the symptoms and course of the disease and the treatment for an adult patient with CHD who has been infected with novel nCoV-19.
Subject(s)
Cardiomegaly , Coronavirus Infections , Cyanosis , Echocardiography/methods , Lung/diagnostic imaging , Pandemics , Pneumonia, Viral , Tetralogy of Fallot , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Betacoronavirus/isolation & purification , COVID-19 , Cardiomegaly/diagnosis , Cardiomegaly/etiology , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Cyanosis/diagnosis , Cyanosis/etiology , Diagnosis, Differential , Diuretics/administration & dosage , Electrocardiography/methods , Humans , Male , Middle Aged , Oximetry/methods , Oxygen Inhalation Therapy/methods , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , SARS-CoV-2 , Tetralogy of Fallot/diagnosis , Tetralogy of Fallot/physiopathology , Tetralogy of Fallot/therapy , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
BACKGROUND: Data regarding coronavirus disease 2019 (COVID-19) cases and outcomes in infants are sparse compared to older pediatric and adult populations. CASE PRESENTATION: We present a three-week-old full-term male with a history of mild hypoxic ischemic encephalopathy (HIE) who was admitted as an inpatient twice for episodes of apnea and perioral cyanosis. The patient tested positive for COVID-19 and negative for other common respiratory viruses at both admissions. CONCLUSIONS: To our knowledge, this is the first report of apnea and perioral cyanosis associated with COVID-19 in an infant. This case highlights a previously undocumented COVID-19 presentation and suggests that even mildly symptomatic infants warrant viral diagnostic testing in an effort to prevent further spread of the disease.