Department of Cardiology, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tehran, Iran.
Department of Cardiology, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Cardiol Young. 2021 Apr;31(4):617-626. doi: 10.1017/S1047951120004400. Epub 2020 Nov 18.
COVD-19 pandemic has overwhelmed many healthcare systems worldwide. Underlying cardiovascular disease predisposes to greater disease susceptibility and more complications including mortality. Such data is unverified in adults with congenital heart disease (ACHD). The aim of the study is to report the Tehran experience with respect to preventative self-care measures, disease exposure, susceptibility, and outcomes after COVD-19 infection in ACHD patients.
A telephone-based survey was conducted in ACHD patients, focusing on new-onset symptoms that might indicate COVID-19 infection, prevention measures, confirmed infection rates, and outcomes.
Three-hundred and nine ACHD patients, with a mean age of 29.13 years (range from 14 to 72 years, SD = 10.64), and 170 (55%) women were assessed. The majority (86.7%) had moderate or complex ACHD. Two-thirds (67.3%) of the patients practiced high-level preventative self-care measures. After community exposure, 33.3% developed COVID-19, and after household exposure, 43.7% developed COVID-19. There was only one mortality in a post-operative patient. Thirty-seven patients (12%) reported new symptoms including cough (10%), fatigue (8%), fever (7%), and new dyspnoea (6.5%). Amongst 18 (6%) with confirmed COVID-19, there was only 1 mortality in a post-operative patient. Age (adjusted OR = 1.19, 95% CI: 1.07-1.31, p = 0.001), contact with confirmed COVID-19 cases (adjusted OR = 59.34, 95% CI: 3.68-955.10, p = 0.004) were independently associated with COVID-19 infection.
Mortality risk associated with COVID-19 infection in ACHD patients with moderate or severe disease appears to be relatively low, similar to the general population. Such risk appears to act through conventional risk factors, and in this cohort, we demonstrated age as a significant risk factor in addition to exposure to the development of COVID-19 infection. Preventative self-care measures are a potentially significant and impactful intervention target for intervention and for improving outcomes.
COVID-19 大流行使全球许多医疗系统不堪重负。潜在的心血管疾病易导致更高的疾病易感性和更多的并发症，包括死亡率。在先天性心脏病（ACHD）成人中，此类数据未经证实。本研究的目的是报告德黑兰在预防自我保健措施、疾病暴露、易感性以及 COVID-19 感染后的结果方面的经验。
对 ACHD 患者进行了基于电话的调查，重点关注可能表明 COVID-19 感染的新发病症状、预防措施、确诊感染率和结果。
评估了 309 名 ACHD 患者，平均年龄 29.13 岁（范围为 14 至 72 岁，SD = 10.64），其中 170 名（55%）为女性。大多数（86.7%）患有中度或复杂的 ACHD。三分之二（67.3%）的患者采取了高水平的预防自我保健措施。在社区暴露后，33.3%的患者出现 COVID-19，在家庭暴露后，43.7%的患者出现 COVID-19。只有一名术后患者死亡。37 名患者（12%）报告了新症状，包括咳嗽（10%）、疲劳（8%）、发烧（7%）和新呼吸困难（6.5%）。在 18 名（6%）确诊 COVID-19 的患者中，只有一名术后患者死亡。年龄（调整后的 OR = 1.19，95%CI：1.07-1.31，p = 0.001）、与确诊 COVID-19 病例的接触（调整后的 OR = 59.34，95%CI：3.68-955.10，p = 0.004）与 COVID-19 感染独立相关。
在患有中度或重度疾病的 ACHD 患者中，COVID-19 感染相关的死亡率似乎相对较低，与一般人群相似。这种风险似乎通过常规风险因素起作用，在本队列中，我们除了暴露于 COVID-19 感染的发展外，还证明了年龄是一个重要的风险因素。预防自我保健措施是一个潜在的重要和有影响力的干预目标，可用于干预和改善结果。
