Ruperti-Repilado Francisco Javier, Baumgartner Helmut, Bouma Berto, Bouchardy Judith, Budts Werner, Campens Laurence, Chessa Massimo, Jesús Del Cerro Marin Maria, Gabriel Harald, Gallego Pastora, González Elvira Ana, Jensen Annette Schophuus, Ladouceur Magalie, Lockhart Christopher, Miranda-Barrio Berta, Morissens Marielle, Escobar Eduardo Moreno, Pasquet Agnès, Soriano Joaquin Rueda, Elise van den Bosch Annemien, Berdina van der Zwaan Heleen, Tobler Daniel, Greutmann Matthias, Schwerzmann Markus
Centre for Congenital Heart Disease, Cardiology, University Hospital Inselspital, University of Bern, Switzerland.
Division of Cardiology, University Hospital of Basel, University of Basel, Switzerland.
Int J Cardiol Congenit Heart Dis. 2023 Mar;11:100428. doi: 10.1016/j.ijcchd.2022.100428. Epub 2022 Nov 21.
At the beginning of the COVID-19 pandemic, professionals in charge of particularly vulnerable populations, such as adult congenital heart disease (ACHD) patients, were confronted with difficult decision-making. We aimed to assess changes in risk stratification and outcomes of ACHD patients suffering from COVID-19 between March 2020 and April 2021.
Risk stratification among ACHD experts (before and after the first outcome data were available) was assessed by means of questionnaires. In addition, COVID-19 cases and the corresponding patient characteristics were recorded among participating centres. Predictors for the outcome of interest (complicated disease course) were assessed by means of multivariable logistic regression models calculated with cluster-robust standard errors. When assessing the importance of general and ACHD specific risk factors for a complicated disease course, their overall importance and the corresponding risk perception among ACHD experts decreased over time. Overall, 638 patients (n = 168 during the first wave and n = 470 during the subsequent waves) were included (median age 34 years, 52% women). Main independent predictors for a complicated disease course were male sex, increasing age, a BMI >25 kg/m2, having ≥2 comorbidities, suffering from a cyanotic heart disease or having suffered COVID-19 in the first wave vs. subsequent waves.
Apart from cyanotic heart disease, general risk factors for poor outcome in case of COVID-19 reported in the general population are equally important among ACHD patients. Risk perception among ACHD experts decreased during the course of the pandemic.
在新冠疫情初期，负责特别脆弱人群（如成人先天性心脏病（ACHD）患者）的专业人员面临艰难的决策。我们旨在评估2020年3月至2021年4月期间感染新冠病毒的ACHD患者风险分层和预后的变化。
通过问卷调查评估ACHD专家（在第一批结局数据可用之前和之后）的风险分层。此外，参与研究的中心记录了新冠病例及相应的患者特征。通过使用聚类稳健标准误计算的多变量逻辑回归模型评估感兴趣结局（疾病过程复杂）的预测因素。在评估一般和ACHD特定风险因素对疾病过程复杂的重要性时，随着时间推移，它们的总体重要性以及ACHD专家相应的风险认知有所下降。总体而言，纳入了638例患者（第一波期间n = 168例，后续波次期间n = 470例）（中位年龄34岁，52%为女性）。疾病过程复杂的主要独立预测因素为男性、年龄增加、BMI>25 kg/m²、合并症≥2种、患有青紫型心脏病或在第一波与后续波次中感染新冠病毒。
除青紫型心脏病外，普通人群中报道的新冠病毒感染预后不良的一般风险因素在ACHD患者中同样重要。在疫情期间，ACHD专家的风险认知有所下降。
