Impact of Coronavirus Disease 2019 (COVID‐19) on Patients With Congenital Heart Disease Across the Lifespan: The Experience of an Academic Congenital Heart Disease Center in New York City

Lewis, Matthew J.; Anderson, Brett R.; Fremed, Michael; Argenio, Melissa; Krishnan, Usha; Weller, Rachel; Levasseur, Stéphanie; Sommer, Robert; Lytrivi, Irene D.; Bacha, Emile A.; Vincent, Julie; Chung, Wendy K.; Rosenzweig, Erika B.; Starc, Thomas J.; Rosenbaum, Marlon

BACKGROUND: We sought to assess the impact and predictors of coronavirus disease 2019 (COVID‐19) infection and severity in a cohort of patients with congenital heart disease (CHD) at a large CHD center in New York City. METHODS AND RESULTS: We performed a retrospective review of all individuals with CHD followed at Columbia University Irving Medical Center who were diagnosed with COVID‐19 between March 1, 2020 and July 1, 2020. The primary end point was moderate/severe response to COVID‐19 infection defined as (1) death during COVID‐19 infection; or (2) need for hospitalization and/or respiratory support secondary to COVID‐19 infection. Among 53 COVID‐19‐positive patients with CHD, 10 (19%) were <18 years of age (median age 34 years of age). Thirty‐one (58%) had complex congenital anatomy including 10 (19%) with a Fontan repair. Eight (15%) had a genetic syndrome, 6 (11%) had pulmonary hypertension, and 9 (17%) were obese. Among adults, 18 (41%) were physiologic class C or D. For the entire cohort, 9 (17%) had a moderate/severe infection, including 3 deaths (6%). After correcting for multiple comparisons, the presence of a genetic syndrome (odds ratio [OR], 35.82; P=0.0002), and in adults, physiological Stage C or D (OR, 19.38; P=0.002) were significantly associated with moderate/severe infection. CONCLUSIONS: At our CHD center, the number of symptomatic patients with COVID‐19 was relatively low. Patients with CHD with a genetic syndrome and adults at advanced physiological stage were at highest risk for moderate/severe infection.