COVID-19 in Adults With Congenital Heart Disease

Craig S. Broberg, Adrienne H. Kovacs, Soraya Sadeghi, Marlon S. Rosenbaum, Matthew J. Lewis, Matthew R. Carazo, Fred H. Rodriguez, Dan G. Halpern, Jodi Feinberg, Francisca Arancibia Galilea, Fernando Baraona, Ari M. Cedars, Jong M. Ko, Prashob Porayette, Jennifer Maldonado, Berardo Sarubbi, Flavia Fusco, Alexandra A. Frogoudaki, Amiram Nir, Anisa ChaudhryAnitha S. John, Arsha Karbassi, Arvind K. Hoskoppal, Benjamin P. Frischhertz, Benjamin Hendrickson, Berto J. Bouma, Carla P. Rodriguez-Monserrate, Christopher R. Broda, Daniel Tobler, David Gregg, Efren Martinez-Quintana, Elizabeth Yeung, Eric V. Krieger, Francisco J. Ruperti-Repilado, George Giannakoulas, George K. Lui, Georges Ephrem, Harsimran S. Singh, Hassan MK Almeneisi, Heather L. Bartlett, Ian Lindsay, Jasmine Grewal, Jeremy Nicolarsen, John J. Araujo, Jonathan W. Cramer, Judith Bouchardy, Khalid Al Najashi, Kristi Ryan, Laith Alshawabkeh, Lauren Andrade, Magalie Ladouceur, Markus Schwerzmann, Matthias Greutmann, Pablo Meras, Paolo Ferrero, Payam Dehghani, Poyee P. Tung, Rocio Garcia-Orta, Rose O. Tompkins, Salwa M. Gendi, Scott Cohen, Scott Klewer, Sebastien Hascoet, Shabnam Mohammadzadeh, Shailendra Upadhyay, Stacy D. Fisher, Stephen Cook, Timothy B. Cotts, Jamil A. Aboulhosn

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Background: Adults with congenital heart disease (CHD) have been considered potentially high risk for novel coronavirus disease-19 (COVID-19) mortality or other complications. Objectives: This study sought to define the impact of COVID-19 in adults with CHD and to identify risk factors associated with adverse outcomes. Methods: Adults (age 18 years or older) with CHD and with confirmed or clinically suspected COVID-19 were included from CHD centers worldwide. Data collection included anatomic diagnosis and subsequent interventions, comorbidities, medications, echocardiographic findings, presenting symptoms, course of illness, and outcomes. Predictors of death or severe infection were determined. Results: From 58 adult CHD centers, the study included 1,044 infected patients (age: 35.1 ± 13.0 years; range 18 to 86 years; 51% women), 87% of whom had laboratory-confirmed coronavirus infection. The cohort included 118 (11%) patients with single ventricle and/or Fontan physiology, 87 (8%) patients with cyanosis, and 73 (7%) patients with pulmonary hypertension. There were 24 COVID-related deaths (case/fatality: 2.3%; 95% confidence interval: 1.4% to 3.2%). Factors associated with death included male sex, diabetes, cyanosis, pulmonary hypertension, renal insufficiency, and previous hospital admission for heart failure. Worse physiological stage was associated with mortality (p = 0.001), whereas anatomic complexity or defect group were not. Conclusions: COVID-19 mortality in adults with CHD is commensurate with the general population. The most vulnerable patients are those with worse physiological stage, such as cyanosis and pulmonary hypertension, whereas anatomic complexity does not appear to predict infection severity.

Original languageEnglish (US)
Pages (from-to)1644-1655
Number of pages12
JournalJournal of the American College of Cardiology
Issue number13
StatePublished - Apr 6 2021


  • COVID-19
  • adult congenital heart disease
  • coronavirus
  • hospitalization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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