Outcome of COVID-19-positive children with heart disease and grown-ups with congenital heart disease: A multicentric study from India

BACKGROUND : Outcome data of children with heart disease who acquired COVID-19 infection are limited. AIMS : We sought to analyze outcome data and identify risk factors associated with mortality in children with heart disease and grown-ups with congenital heart disease (GUCH) who had a laboratory-co...

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Detalles Bibliográficos
Autores principales: Sachdeva, Sakshi, Ramakrishnan, Sivasubramanian, Choubey, Mrigank, Koneti, Nageswara Rao, Mani, Kalaivani, Bakhru, Shweta, Gupta, Saurabh Kumar, Gangopadhyay, Debasree, Kasturi, Soumya, Mishra, Jayashree, Nayak, Hemant Kumar, Sivakumar, Kothandam, Bobhate, Prashant, Awasthy, Neeraj, Das, Debasis, Chakrabarti, Manisha, Muthukumaran, Chinnaswamy Sivaprakasam, Saileela, Rajan, Dhulipudi, Bhargavi, Chaudhary, Shiv Kumar, Jayranganath, Mahimarangaiah, Saxena, Anita, Iyer, Krishna Subramony, Kumar, Raman Krishna, Kothari, Shyam S, Kulkarni, Snehal, Rao, Suresh G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8457291/
https://www.ncbi.nlm.nih.gov/pubmed/34667396
http://dx.doi.org/10.4103/apc.apc_134_21
Descripción
Sumario:BACKGROUND : Outcome data of children with heart disease who acquired COVID-19 infection are limited. AIMS : We sought to analyze outcome data and identify risk factors associated with mortality in children with heart disease and grown-ups with congenital heart disease (GUCH) who had a laboratory-confirmed COVID-19 infection. SETTINGS AND DESIGN : This is a retrospective, multicentric, observational study. MATERIALS AND METHODS : The study included children with heart disease and GUCH population, who presented with either symptomatic or asymptomatic COVID-19 infection to any of the participating centers. COVID-19-negative patients admitted to these centers constituted the control group. RESULTS : From 24 pediatric cardiac centers across India, we included 94 patients with a median age of 12.5 (interquartile range 3–96) months and 49 (52.1%) patients were males. Majority (83 patients, 88.3%) were children. One-third of the patients (n = 31, 33.0%) had acyanotic congenital heart disease, and 41.5% (n = 39) were cyanotic, with > 80% of the patients being unoperated. Only 30 (31.9%) patients were symptomatic for COVID-19 infection, while the rest were incidentally detected positive on screening. A total of 13 patients died (case fatality rate: 13.8%). The in-hospital mortality rate among hospitalized patients was significantly higher among COVID-19-positive cases (13 of 48; 27.1%) as compared to COVID-negative admissions (9.2%) during the study period (P < 0.001). On multivariate analysis, the independent predictors of mortality among COVID-19-positive cases were severity of illness at admission (odds ratio [OR]: 535.7, 95% confidence interval [CI]: 6.9–41,605, P = 0.005) and lower socioeconomic class (OR: 29.5, 95% CI: 1.1–814.7, P = 0.046). CONCLUSIONS : Children with heart disease are at a higher risk of death when they acquire COVID-19 infection. Systematic preventive measures and management strategies are needed for improving the outcomes.

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