@Article{chd.2022.020174,
AUTHOR = {Fatma A. Taha, Osama Amoudi, Fareed Alnozha, Reda Abuelatta},
TITLE = {Adults with Congenital Heart Disease during the COVID-19 Era: One-Year Tertiary Center Experience},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {17},
YEAR = {2022},
NUMBER = {4},
PAGES = {399--419},
URL = {http://www.techscience.com/schd/v17n4/48756},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> Adult patients with congenital heart disease (ACHD) might be at high risk of Coronavirus disease-
2019 (COVID-19). This study aimed to report on a one-year tertiary center experience regards COVID-19 infection in ACHD patients. Methods: This is a one-year (March-2020 to March-2021) tertiary-center retrospective
study that enrolled all ACHD patients; COVID-19 positive patients’ medical records, and management were
reported. <b>Results: </b>We recorded 542 patients, 205 (37.8%) COVID-19-positive, and 337 (62.2%) COVID-19-negative
patients. Palliated single ventricle and Eisenmenger syndrome patients were more vulnerable to COVID-19 infection
(<i>P</i> < 0.05*). Cardiovascular COVID-19 complications were arrhythmias in 47 (22.9%) patients, heart failure in
39 (19.0%) patients, cyanosis in 12 (5.9%) patients, stroke/TIA in 5 (2.4%) patients, hypertension and infective endocarditis in 2 (1.0%) patients for each, pulmonary hypertension and pulmonary embolism in 1 (0.5%) patient for
each. 11 (5.4%) patients were managed with home isolation, 147 (71.7%) patients required antibiotics,
32 (15.6%) patients required intensive care unit (ICU), 8 (3.9%) patients required inotropes, 7 (3.4%) patients
required mechanical ventilation, and 2 (1.0%) patients required extracorporeal membrane oxygenation (ECMO).
Thromboprophylaxis was given to all 46 (22.4%) hospitalized patients. American College of Cardiology/American
Heart Association classification revealed that complex lesions, and FC-C/D categories were more likely to develop
severe/critical symptoms, that required mechanical ventilation and ECMO (<i>P</i> < 0.05*). Mortality was reported in
3 (0.6%) patients with no difference between groups (<i>P</i> = 0.872). 193 (35.6%) patients were vaccinated. <b>Conclusions:</b>
COVID-19 infection in ACHD patients require individualized risk stratification and management. Eisenmenger
syndrome, single ventricle palliation, complex lesions, and FC-C/D patients were more vulnerable to severe/critical
symptoms that required ICU admission, mechanical ventilation, and ECMO. The vaccine was mostly tolerable.},
DOI = {10.32604/chd.2022.020174}
}