Background

Adults with congenital heart disease (ACHD) are considered to have an increased risk for complications due to COVID-19, especially in those patients with worse physiological stage like cyanosis or heart failure symptoms. However, data regarding the rate of infection in this emerging patient population is currently lacking.

Purpose

To study the rate of COVID-19 infections in ACHD patients from a tertiary centre.

Methods

In this single-centre study, all consecutive ACHD patients (over the age of 18 years) who attended the outpatient clinic of a tertiary centre from January 2021 to March 2021 were eligible to participate. Demographic data, as well as medical/surgical history including a history of a COVID-19 infection were collected. All patients had an antibody test for COVID-19.  

Results

Altogether, 177 patients (39.5% female, mean age 36.2 ± 12.6 years) were included in the study. Congenital heart defect (CHD) complexity according to the Bethesda classification was simple in 31 (17.5%), moderate in 86 (48.6%), complex in 52 (29.4%), and miscellaneous in 8 (4.5%) patients. A positive antibody test for COVID-19 was present in 13 (7.3%) patients (CHD complexity: simple n=3, moderate n=5, severe n=5). Out of these, 8 patients already knew that they had COVID-19, while 5 patients (38.5%) were not aware of their infection. Out of the 13 patients with a positive antibody test, 7 had no symptoms at all (CHD complexity: simple n=1, moderate n=3, severe n=3). There was no significant difference between ACHD patients with a positive test vs those with a negative test regarding age, gender, New York Heart Association class, or complexity of CHD.

Conclusions

In this single-centre study, 7.3% of ACHD patients attending the outpatient clinic had positive antibodies for COVID-19. Out of these, 53.8% were asymptomatic and 38.5% were not aware of their infection. This indicates a large number of undetected cases in the ACHD population.