Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts
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...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-02-01
|
| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/1/e001455.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846170510232125440 |
|---|---|
| author | Markus Schwerzmann Marielle Morissens Matthias Greutmann Pastora Gallego Annette Schophuus Jensen Massimo Chessa Daniel Tobler Gerhard Diller Laura Dos-Subirà Magalie Ladouceur Francisco Javier Ruperti-Repilado Berto Bouma Judith Bouchardy Harald Gabriel Agnes Pasquet Julie De Backer Rocío García Orta María Elvira Rodríguez-Monte Garrido-Lestache Elvira Ana González Pablo Meras Berta Miranda Joaquin Rueda Soriano Oktay Tutare Annemien van den Bosch Heleen van der Zwaan |
| author_facet | Markus Schwerzmann Marielle Morissens Matthias Greutmann Pastora Gallego Annette Schophuus Jensen Massimo Chessa Daniel Tobler Gerhard Diller Laura Dos-Subirà Magalie Ladouceur Francisco Javier Ruperti-Repilado Berto Bouma Judith Bouchardy Harald Gabriel Agnes Pasquet Julie De Backer Rocío García Orta María Elvira Rodríguez-Monte Garrido-Lestache Elvira Ana González Pablo Meras Berta Miranda Joaquin Rueda Soriano Oktay Tutare Annemien van den Bosch Heleen van der Zwaan |
| author_sort | Markus Schwerzmann |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-2c81fa9971474cada7507ccdce939e29 |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-2c81fa9971474cada7507ccdce939e292024-11-11T17:05:09ZengBMJ Publishing GroupOpen Heart2053-36242021-02-018110.1136/openhrt-2020-001455Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European expertsMarkus Schwerzmann0Marielle Morissens1Matthias Greutmann2Pastora Gallego3Annette Schophuus JensenMassimo Chessa4Daniel Tobler5Gerhard DillerLaura Dos-Subirà6Magalie Ladouceur7Francisco Javier Ruperti-Repilado8Berto Bouma9Judith Bouchardy10Harald Gabriel11Agnes Pasquet12Julie De BackerRocío García OrtaMaría ElviraRodríguez-Monte Garrido-LestacheElvira Ana GonzálezPablo MerasBerta MirandaJoaquin Rueda SorianoOktay TutareAnnemien van den BoschHeleen van der Zwaan1 Center for Congenital Heart Disease, Cardiology, Inselspital University Hospital Bern, University of Bern, Bern, SwitzerlandDepartment of Cardiology, CHU Brugmann, Brussels, BelgiumAdult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, Zurich, Switzerland8 Adult Congenital Heart Disease Unit, Instituto de BioMedicina de Sevilla (IBIS) and CIBERCV, Virgen del Rocio University Hospital Cardiology and Cardiovascular Surgery Service, Sevilla, Spain4 Pediatric Cardiology Department and GUCH Unit, IRCCS Policlinico San Donato, San Donato Milanese, ItalyUniversity Heart Center, University Hospital Basel, Basel, SwitzerlandAdult Congenital Heart Disease Unit, Vall d`Hebron University Hospital, Barcelona, SpainHôpitaux universitaires de Genève, Genève, Switzerland1 Center for Congenital Heart Disease, Cardiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland10 Department of Cardiology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands4 Cardiovascular Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland9 Adult Congenital Heart Disease Centre, Medical University of Vienna, Wien, AustriaDivision of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD) Institut de Recherche Expérimentale et Clinique (IREC) Université Catholique de Louvain, Brussels, BelgiumObjective 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.https://openheart.bmj.com/content/8/1/e001455.full |
| spellingShingle | Markus Schwerzmann Marielle Morissens Matthias Greutmann Pastora Gallego Annette Schophuus Jensen Massimo Chessa Daniel Tobler Gerhard Diller Laura Dos-Subirà Magalie Ladouceur Francisco Javier Ruperti-Repilado Berto Bouma Judith Bouchardy Harald Gabriel Agnes Pasquet Julie De Backer Rocío García Orta María Elvira Rodríguez-Monte Garrido-Lestache Elvira Ana González Pablo Meras Berta Miranda Joaquin Rueda Soriano Oktay Tutare Annemien van den Bosch Heleen van der Zwaan Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts Open Heart |
| title | Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts |
| title_full | Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts |
| title_fullStr | Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts |
| title_full_unstemmed | Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts |
| title_short | Risk stratification of adults with congenital heart disease during the COVID-19 pandemic: insights from a multinational survey among European experts |
| title_sort | risk stratification of adults with congenital heart disease during the covid 19 pandemic insights from a multinational survey among european experts |
| url | https://openheart.bmj.com/content/8/1/e001455.full |
| work_keys_str_mv | AT markusschwerzmann riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT mariellemorissens riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT matthiasgreutmann riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT pastoragallego riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT annetteschophuusjensen riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT massimochessa riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT danieltobler riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT gerharddiller riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT lauradossubira riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT magalieladouceur riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT franciscojavierrupertirepilado riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT bertobouma riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT judithbouchardy riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT haraldgabriel riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT agnespasquet riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT juliedebacker riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT rociogarciaorta riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT mariaelvira riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT rodriguezmontegarridolestache riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT elviraanagonzalez riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT pablomeras riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT bertamiranda riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT joaquinruedasoriano riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT oktaytutare riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT annemienvandenbosch riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts AT heleenvanderzwaan riskstratificationofadultswithcongenitalheartdiseaseduringthecovid19pandemicinsightsfromamultinationalsurveyamongeuropeanexperts |