Trends in mortality risk of patients with congenital heart disease during the COVID-19 pandemic
Main finding · All-cause mortalityResult — go to the resultAdjusted hazard ratio 1.28 95% CI 1.08–1.53Authors' conclusion
In this large CHD cohort study, there was a higher risk of death among CHD patients with male and chromosomal abnormalities. A differential trend towards higher risk for those with two vs. unchanged risk for single ventricle CHD was presented. The excess mortality was attributed to the COVID-19 itself and not to conditions potentially related to deferral of care.
Study context
- Population
- US patients with congenital heart disease (CHD) from a US registry of CHD interventions, observation 2017–2022median age in 2017: 23.3 years
- Participants
- 45,130 patients
- Exposure
- COVID-19 era vs pre-COVID-19 era
- Outcome
- All-cause mortality
Methodological detailsregistry-based (Pediatric Cardiac Care Consortium), stratified Cox model
- Registry-based (Pediatric Cardiac Care Consortium)
- Stratified Cox model
Main finding
As reported in the abstract
Adjusted hazard ratio
1.28
95% CI 1.08–1.53
COVID-19 eravs Pre-COVID-19 era
aHR 1.28 (95% CI 1.08–1.53)
- Deaths during the pandemic
- 503
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| All-cause mortality, by ventricular physiology (subgroup)COVID-19 eravs Pre-COVID-19 eraTwo-ventricle CHD | 1.44 (1.19–1.76) | |
| All-cause mortality, by ventricular physiology (subgroup)COVID-19 eravs Pre-COVID-19 eraSingle ventricle CHD (unchanged risk) | 0.83 (0.57–1.21) | |
| 0.512Adjusted hazard ratio (log scale) |
Deaths during the pandemic and deaths attributed to COVID-19
- Deaths during the pandemic
- 503
- Deaths attributed to COVID-19
- 44 (8.7%)
- COVID-19 mortality rate
- 0.09%
All-cause mortality, by sex and chromosomal abnormalities (adjusted subgroup)
- Higher risk of death during the pandemic for male CHD patients and those with chromosomal abnormalities
Cause of excess deaths
- Excess deaths during the pandemic attributed to COVID-19 itself rather than CHD or CV conditions
Original publication
Trends in mortality risk of patients with congenital heart disease during the COVID-19 pandemic. Am Heart J. Published 14 November 2023. doi:10.
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