COVID-19–Related Thrombotic and Bleeding Events in Adults With Congenital Heart Disease
Authors' conclusion
ACHD patients with TE/bleeding during COVID-19 infection have a higher in-hospital mortality from the illness. Risk of coagulation disorders is related to severe COVID-19, cardiac injury during infection, and use of anticoagulants.
Study context
- Population
- COVID-19-positive adults with congenital heart disease (ACHD), 59 ACHD centres, May 2020–November 2021
- Participants
- 1,988 adults · 59 ACHD centers
- Exposure
- ACHD patients with vs without thromboembolic (TE)/bleeding complications during COVID-19
- TE/bleedingn = 30
- Outcome
- Prevalence and risk factors for COVID-19 TE/bleeding complications
Main finding
As reported in the abstract
TE/bleeding complications
TE/bleeding
1.5%
30 of 30
Each group vs remainderOdds ratio (95% CI)P value
Prior anticoagulation
4.92(2–11.76)
P = 0.0003Cardiac injury
5.34(1.98–14.76)
P = 0.0009Severe COVID-19
17.39(6.67–45.32)
P < 0.0001Observational data: associations, not effects.
Further findings
In-hospital mortality
P < 0.0001
Characteristics of TE/bleeding vs remainder
- More advanced physiological stage
- P = 0.032
- Higher NYHA functional class
- P = 0.01
- Lower baseline oxygen saturation
- P = 0.0001
- More frequent history of atrial arrhythmia
- P < 0.0001
- More previous hospitalization for HF
- P < 0.0007
- More likely hospitalized for COVID-19
- P < 0.0001
Original publication
COVID-19–Related Thrombotic and Bleeding Events in Adults With Congenital Heart Disease. JACC Adv. Published 21 November 2023. doi:10.
Summarised from the published abstract; every number is checked against it