RESUMEN
Background: Adults with congenital heart disease (ACHD) are considered at increased risk for complications due to COVID-19, especially in those with cyanosis or heart failure. However, data regarding the rate of infection as well as regarding a myocardial involvement of a COVID-19 infection in ACHD patients are currently lacking. Purpose(s): To study the rate of COVID-19 infections in ACHD patients from a tertiary centre as well as the rate of myocardial involvement of a COVID- 19 infection. Method(s): All consecutive ACHD patients (over the age of 18 years) who attended the outpatient clinic of a tertiary centre from January 2021 to June 2021 were eligible to participate. Demographic data, as well as medical/ surgical data including a history of a COVID-19 infection were collected. All patients had an antibody test for COVID-19. Patients with a positive antibody test were offered cardiovascular magnetic resonance imaging (CMR). Result(s): Altogether, 420 patients (44.8% female, mean age 36.4+/-11.6 years) were included in the study. Congenital heart defect (CHD) complexity according to the Bethesda classification was simple in 96 (22.9%), moderate in 186 (44.3%), complex in 117 (27.9%), and miscellaneous in 21 (5.0%) patients. A positive antibody test for COVID-19 was present in 28 (6.7%) patients (CHD complexity: Simple n=5, moderate n=14, severe n=7, miscellaneous n=2). Out of these 28 patients, 14 had no symptoms at all. Those with symptoms had mainly mild symptoms and were all managed in the outpatient setting. While 11 patients (39.3%) were not at all aware of their infection, 17 already knew that they had COVID-19. There was no significant difference between ACHD patients with a positive test vs those with a negative test regarding age, gender, New York Heart Association class, or complexity of CHD. Out of the 28 patients with a positive antibody test, 14 agreed to a CMR. A myocardial involvement, i.e. signs of active or healed myocarditis, was not present in any of these. Conclusion(s): In this single-centre study, 6.7% of ACHD patients attending the outpatient clinic had positive antibodies for COVID-19. Out of these, 50% were asymptomatic and 39.3% were not aware of their infection. A myocardial involvement was not found in any of the patients that underwent a CMR. These results indicate a large number of undetected cases of COVID-19 in the ACHD population and offer reassurance that in the vast majority of cases the infection has a mild course.
RESUMEN
Background: Adults with congenital heart disease (ACHD) are considered at increased risk for complications due to COVID-19, especially in those with cyanosis or heart failure. However, data regarding the rate of infection as well as regarding a myocardial involvement of a COVID-19 infection in ACHD patients are currently lacking. Purpose: To study the rate of COVID-19 infections in ACHD patients from a tertiary centre as well as the rate of myocardial involvement of a COVID-19 infection. Methods: All consecutive ACHD patients (over the age of 18 years) who attended the outpatient clinic of a tertiary centre from January 2021 to June 2021 were eligible to participate. Demographic data, as well as medical/surgical data including a history of a COVID-19 infection were collected. All patients had an antibody test for COVID-19. Patients with a positive antibody test were offered cardiovascular magnetic resonance imaging (CMR). Results: Altogether, 420 patients (44.8% female, mean age 36.4±11.6 years) were included in the study. Congenital heart defect (CHD) complexity according to the Bethesda classification was simple in 96 (22.9%), moderate in 186 (44.3%), complex in 117 (27.9%), and miscellaneous in 21 (5.0%) patients. A positive antibody test for COVID-19 was present in 28 (6.7%) patients (CHD complexity: simple n=5, moderate n=14, severe n=7, miscellaneous n=2). Out of these 28 patients, 14 had no symptoms at all. Those with symptoms had mainly mild symptoms and were all managed in the outpatient setting. While 11 patients (39.3%) were not at all aware of their infection, 17 already knew that they had COVID-19. There was no significant difference between ACHD patients with a positive test vs those with a negative test regarding age, gender, New York Heart Association class, or complexity of CHD. Out of the 28 patients with a positive antibody test, 14 agreed to a CMR. A myocardial involvement, i.e. signs of active or healed myocarditis, was not present in any of these. Conclusions: In this single-centre study, 6.7% of ACHD patients attending the outpatient clinic had positive antibodies for COVID-19. Out of these, 50% were asymptomatic and 39.3% were not aware of their infection. A myocardial involvement was not found in any of the patients that underwent a CMR. These results indicate a large number of undetected cases of COVID-19 in the ACHD population and offer reassurance that in the vast majority of cases the infection has a mild course. Funding Acknowledgement: Type of funding sources: Public Institution(s). Main funding source(s): Bayerisches Staatsministerium für Wissenschaft und Kunst
RESUMEN
Introduction: Social distancing, extensive bans on contacts, curfews, and required wearing of masks in public places have -while unavoidable for disease containment purposes -caused major disruptions to everyday life in face of the Coronavirus Disease 2019 (COVID-19) pandemic. The aim of this study was to figure out how the COVID-19 pandemic affects the Health-related Quality of Life (HRQoL) of children and adolescents with CHD, as well as how the parents perceive the HRQoL of their children. Methods: HRQoL was assessed by KINDL® questionnaire during the COVID-19 pandemic and compared to the children's most recent completion of the questionnaire out of the FOOTLOOSE study setting (German-Clinical-Trial-Register-ID: DRKS00018853) at the outpatient department of the German Heart Center Munich (DHM). From May 27th to June 29th 2020, 160 German children with various CHD (15.2 ± 2.5 years, 62 girls) completed this re-assessment of HRQoL. Mean follow-up period was 2.1 ± 1.7 years. Difference between children's self-reported HRQoL and parents' proxy report was calculated with a paired student T-Test, and agreement of the respective ratings with intraclass correlation coefficient (ICC) and their 95% confidence intervals. Results: HRQoL in children with CHD was significantly lower during COVID-19 pandemic compared to before in total KINDL® score (by -2.1 ± 12.3, p=.030), and the subcategories emotional well-being (by -5.4 ± 1.2, p<.001) and friends (by -4.5 ± 1.7, p=.009). Parents of children with CHD rate the HRQoL in total KINDL® score (mean difference: 3.9 ± 1.2, p=.002), and the subcategories family (mean difference: 8.8 ± 1.7 SEE, p<.001) and friends (mean difference: 7.6 ± 2.2 SEE, p<.001) even worse than their children. Only moderate degree of agreement was found between most of the sub-categorical HRQoL assessment of children with CHD and their parents. Conclusions: The COVID-19 pandemic had a negative impact on HRQoL in children and adolescents with CHD and their families. Furthermore, parents rate the HRQoL of their chronically ill children even worse than the children themselves. Specifically, psychological concerns of children with CHD and their families should also be considered by health care providers during the COVID-19 pandemic.