Presentation and Outcome of Congenital Heart Disease During Covid-19 Pandemic: A Review

Abstract

Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-COV 2 ) infection is a rapid evolving pandemic with multiple peaks of outbreak and substantial mortality worldwide. It has been proposed that infants are more vulnerable to SARS-COV-2 infection. On the other hand, children with COVID-19 have generally milder disease compared to infected adults and more often presented with gastrointestinal symptoms compared to respiratory ones. Multisystem inflammatory syndrome in children (MIS-c) is an ominous demonstration of COVID-19 with cardiac involvement and mortality rate <2%. From cardiovascular point of view, wide spectrum of manifestations including subclinical myocardial injury, myocarditis, stress cardiomyopathies, cardiac arrhythmias, pulmonary thromboembolism and thrombus formation in cardiac chambers and vascular bed has been reported in COVID-19 disease . Congenital heart disease (CHD), assumed as the most prevalent form of congenital disease. Advances in medical and surgical treatments for CHD have led to more alive patients with underlying heart disease secondary to congenital defects. These group of pediatric patients are prone to heart failure, arrhythmia and embolic events. In this narrative review, we intended to evaluate the cardiovascular and pediatric presentations of COVID-19 as well as the manifestation and outcomes of SARS-CoV-2 infection on pediatric patients with CHD.

Hematological indices in pediatric patients with acyanotic congenital heart disease: a cross-sectional study of 248 patients

“…Numerous studies have indicated that viral respiratory infections, including influenza and COVID-19, impose a higher risk of mortality, a longer duration of hospitalization, and more complications and economic costs in patients with CHD than the general population [6,[37][38][39].…”

Clinical outcomes of COVID-19 infection in congenital heart disease: A single-center experience in Indonesia

“…Therefore, our findings on nearly 50% of subjects presenting severe and critical COVID-19 should be analyzed further. These findings might be due to the impact of CHD on COVID-19 progression, the worsening of the CHD condition itself, the interaction between both conditions, or possible bias caused by the study population of only hospitalized patients ( 33 – 35 ).…”

A systematic review of current status and challenges of vaccinating children against SARS-CoV-2

“…Secondly, less than 9% developed mild or moderate SARS-CoV-2 post-infectious MIS-C within 4–6 weeks of infection and inflammatory dysfunction of various degrees in multiple systems, such as mucocutaneous, gastrointestinal and cardiovascular, throughout the body ( Fig. 2 B) [72] , [79] , [80] , [81] , [82] . Thirdly, a small amount of patients with severe underlying diseases or moderate MIS-C without timely intervention, deteriorated and eventually progress to severe and critical disease, which included multiple organ failure (MOF) or death.…”