RT Journal Article
SR Electronic
T1 Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e001455
DO 10.1136/openhrt-2020-001455
VO 8
IS 1
A1 Francisco Javier Ruperti-Repilado
A1 Daniel Tobler
A1 Matthias Greutmann
A1 Judith Bouchardy
A1 Magalie Ladouceur
A1 Laura Dos-Subira
A1 Pastora Gallego
A1 Harald Gabriel
A1 Berto Bouma
A1 Markus Schwerzmann
A1 ,
YR 2021
UL http://openheart.bmj.com/content/8/1/e001455.abstract
AB Objective Adults with congenital heart disease (ACHD) may be at a higher risk of a fatal outcome in case of COVID-19. Current risk stratification among these patients relies on personal experience and extrapolation from patients with acquired heart disease. We aimed to provide an expert view on risk stratification while awaiting results from observational studies.Methods This study was an initiative of the EPOCH (European Collaboration for Prospective Outcome Research in Congenital Heart disease). Among nine European countries (Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain and Switzerland), 24 experts from 23 tertiary ACHD centres participated in the survey. ACHD experts were asked to identify ACHD-specific COVID-19 risk factors from a list of potential outcome predictors and to estimate the risk of adverse COVID-19 outcomes in seven commonly seen patient scenarios.Results 82% of participants did not consider all ACHD patients at risk of COVID-19 related complications. There was a consensus on pulmonary arterial hypertension, Fontan physiology and cyanotic heart disease as risk factors for adverse outcomes. Among different ACHD scenarios, a patient with Eisenmenger syndrome was considered to be at the highest risk. There was a marked variability in risk estimation among the other potential outcome predictors and ACHD scenarios.Conclusions Pulmonary arterial hypertension, Fontan palliation and cyanotic heart disease were widely considered as risk factors for poor outcome in COVID-19. However, there was a marked disparity in risk estimation for other clinical scenarios. We are in urgent need of outcome studies in ACHD suffering from COVID-19.Data are available upon reasonable request.