Annals of Pediatric Cardiology (Jan 2021)

Outcome of COVID-19-positive children with heart disease and grown-ups with congenital heart disease: A multicentric study from India

  • Sakshi Sachdeva,
  • Sivasubramanian Ramakrishnan,
  • Mrigank Choubey,
  • Nageswara Rao Koneti,
  • Kalaivani Mani,
  • Shweta Bakhru,
  • Saurabh Kumar Gupta,
  • Debasree Gangopadhyay,
  • Soumya Kasturi,
  • Jayashree Mishra,
  • Hemant Kumar Nayak,
  • Kothandam Sivakumar,
  • Prashant Bobhate,
  • Neeraj Awasthy,
  • Debasis Das,
  • Manisha Chakrabarti,
  • Chinnaswamy Sivaprakasam Muthukumaran,
  • Rajan Saileela,
  • Bhargavi Dhulipudi,
  • Shiv Kumar Chaudhary,
  • Mahimarangaiah Jayranganath,
  • Anita Saxena,
  • Krishna Subramony Iyer,
  • Raman Krishna Kumar,
  • Shyam S Kothari,
  • Snehal Kulkarni,
  • Suresh G Rao,
  • For the PCSI-COVID-19 study group

DOI
https://doi.org/10.4103/apc.apc_134_21
Journal volume & issue
Vol. 14, no. 3
pp. 269 – 277

Abstract

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Background : Outcome data of children with heart disease who acquired COVID-19 infection are limited. Aims : We sought to analyze outcome data and identify risk factors associated with mortality in children with heart disease and grown-ups with congenital heart disease (GUCH) who had a laboratory-confirmed COVID-19 infection. Settings and Design : This is a retrospective, multicentric, observational study. Materials and Methods : The study included children with heart disease and GUCH population, who presented with either symptomatic or asymptomatic COVID-19 infection to any of the participating centers. COVID-19-negative patients admitted to these centers constituted the control group. Results : From 24 pediatric cardiac centers across India, we included 94 patients with a median age of 12.5 (interquartile range 3–96) months and 49 (52.1%) patients were males. Majority (83 patients, 88.3%) were children. One-third of the patients (n = 31, 33.0%) had acyanotic congenital heart disease, and 41.5% (n = 39) were cyanotic, with > 80% of the patients being unoperated. Only 30 (31.9%) patients were symptomatic for COVID-19 infection, while the rest were incidentally detected positive on screening. A total of 13 patients died (case fatality rate: 13.8%). The in-hospital mortality rate among hospitalized patients was significantly higher among COVID-19-positive cases (13 of 48; 27.1%) as compared to COVID-negative admissions (9.2%) during the study period (P < 0.001). On multivariate analysis, the independent predictors of mortality among COVID-19-positive cases were severity of illness at admission (odds ratio [OR]: 535.7, 95% confidence interval [CI]: 6.9–41,605, P = 0.005) and lower socioeconomic class (OR: 29.5, 95% CI: 1.1–814.7, P = 0.046). Conclusions : Children with heart disease are at a higher risk of death when they acquire COVID-19 infection. Systematic preventive measures and management strategies are needed for improving the outcomes.

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