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Characteristics and outcomes of acute COVID-19 infection in paediatric and young adult patients with underlying cardiac disease

Part of: Infectious

Published online by Cambridge University Press:  30 September 2021

Joshua M. Fisher
Affiliation:
Division of General Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, USA
Sarah Badran
Affiliation:
Department of Pediatrics, Children’s Hospital Los Angeles Heart Institute, Los Angeles, CA, USA
John T. Li
Affiliation:
Department of Anesthesia and Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA
Jodie K. Votava-Smith
Affiliation:
Department of Pediatrics, Children’s Hospital Los Angeles Heart Institute, Los Angeles, CA, USA
Patrick M. Sullivan*
Affiliation:
Department of Pediatrics, Children’s Hospital Los Angeles Heart Institute, Los Angeles, CA, USA
*
Author for correspondence: Patrick M Sullivan, MD, Children’s Hospital Los Angeles Heart Institute, 4650 Sunset Blvd. #34 Los Angeles, CA 90027, USA. Tel: 323 361 6590; Fax: 323 361 1513. E-mail: psullivan@chla.usc.edu

Abstract

Objective

To describe outcomes of acute coronavirus disease 2019 in paediatric and young adult patients with underlying cardiac disease and evaluate the association between cardiac risk factors and hospitalisation.

Study design

We conducted a retrospective single-institution review of patients with known cardiac disease and positive severe acute respiratory syndrome coronavirus 2 RT-PCR from 1 March, 2020 to 30 November, 2020. Extracardiac comorbidities and cardiac risk factors were compared between those admitted for coronavirus disease 2019 illness and the rest of the cohort using univariate analysis.

Results

Forty-two patients with a mean age of 7.7 ± 6.7 years were identified. Six were 18 years of age or more with the oldest being 22 years of age. Seventy-six percent were Hispanic. The most common cardiac diagnoses were repaired cyanotic (n = 7, 16.6%) and palliated single ventricle (n = 7, 16.6%) congenital heart disease. Fourteen patients (33.3%) had underlying syndromes or chromosomal anomalies, nine (21%) had chronic pulmonary disease and eight (19%) were immunosuppressed. Nineteen patients (47.6%) reported no symptoms. Sixteen (38.1%) reported only mild symptoms. Six patients (14.3%) were admitted to the hospital for acute coronavirus disease 2019 illness. Noncardiac comorbidities were associated with an increased risk of hospitalisation (p = 0.02), particularly chronic pulmonary disease (p = 0.01) and baseline supplemental oxygen requirement (p = 0.007). None of the single ventricle patients who tested positive required admission.

Conclusions

Hospitalisations for coronavirus disease 2019 were rare among children and young adults with underlying cardiac disease. Extracardiac comorbidities like pulmonary disease were associated with increased risk of hospitalisation while cardiac risk factors were not.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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