People with heart defects may be at greater risk for severe COVID-19
illness
Date:
March 7, 2022
Source:
American Heart Association
Summary:
People with congenital heart defects who were hospitalized with
COVID-19 were up to twice as likely to suffer severe illness or
death from the virus compared to people who were not born with a
heart defect, according to a new study. People with a heart defect
plus another underlying medical condition, including heart failure,
pulmonary hypertension, Down syndrome, diabetes or obesity, were
among those most at risk of having severe COVID-19 illness.
FULL STORY ========================================================================== 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. Researchers found people with a congenital heart defect
who contracted COVID-19 were also more likely to require treatment in
the intensive care unit (ICU) or need a ventilator.
========================================================================== Among those at the highest risk for the most severe COVID-19 illness
were patients who had a heart defect and another health condition,
were ages 50 and older, or were men, according to the study.
There are more than a dozen types of congenital heart defects, which
result when the heart, or blood vessels near the heart don't develop
normally before birth. According to the American Heart Association's Heart Disease and Stroke Statistics -- 2022 Update, 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 and the COVID-19 Response Team
at the U.S. Centers for Disease Control and Prevention in Atlanta.
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. 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. Across these two categories, researchers then determined how
many required an admission to the ICU, needed a ventilator to help with breathing or died.
Researchers also reviewed other characteristics including other health conditions.
Of the 235,638 hospitalized COVID-19 patients evaluated for this study,
421 or 0.2% had a congenital heart defect. The analysis found:
* among the patients with a heart defect, most were over the age of 30
(73%), and 61% were male; 55% were non-Hispanic white people, 19%
were Hispanic people and 16% were non-Hispanic Black people;
* overall, 68% of the patients with a heart defect also had at
least one
other health condition noted, compared to 59% among those without
a congenital heart defect;
* 54% of patients with a congenital heart defect were admitted to
the ICU
compared to 43% of those without a congenital heart defect;
* 24% of patients with a congenital heart defect required a
ventilator to
breathe compared to 15% of those without a congenital heart
defect; and
* 11% of patients with a congenital heart defect died during
hospitalization compared to 7% of those without a congenital
heart defect.
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.
Downing believes these findings have immediate, practical relevance
for health care professionals as the COVID-19 pandemic continues to
evolve: "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." Downing noted that not all patients with
heart defects who were hospitalized with COVID-19 had poor outcomes. "More
work is 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," she said.
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.
Co-authors are Regina Simeone, Ph.D.; Matthew Oster, M.D., M.P.H.;
and Sherry Farr, Ph.D. Authors' disclosures are listed in the manuscript.
========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.
========================================================================== Journal Reference:
1. Karrie F. Downing, Regina M. Simeone, Matthew E. Oster, Sherry
L. Farr.
Critical Illness Among Patients Hospitalized With Acute COVID-19
With and Without Congenital Heart Defects. Circulation, 2022; DOI:
10.1161/ CIRCULATIONAHA.121.057833 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/03/220307082327.htm
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