Impact of Coronavirus Disease 2019 (COVID-19) on Patients With Congenital Heart Disease Across the Lifespan: The Experience of an Academic Congenital Heart Disease Center in New York City

J Am Heart Assoc. 2020 Dec;9(23):e017580. doi: 10.1161/JAHA.120.017580. Epub 2020 Oct 14.


Background We sought to assess the impact and predictors of coronavirus disease 2019 (COVID-19) infection and severity in a cohort of patients with congenital heart disease (CHD) at a large CHD center in New York City. Methods and Results We performed a retrospective review of all individuals with CHD followed at Columbia University Irving Medical Center who were diagnosed with COVID-19 between March 1, 2020 and July 1, 2020. The primary end point was moderate/severe response to COVID-19 infection defined as (1) death during COVID-19 infection; or (2) need for hospitalization and/or respiratory support secondary to COVID-19 infection. Among 53 COVID-19-positive patients with CHD, 10 (19%) were <18 years of age (median age 34 years of age). Thirty-one (58%) had complex congenital anatomy including 10 (19%) with a Fontan repair. Eight (15%) had a genetic syndrome, 6 (11%) had pulmonary hypertension, and 9 (17%) were obese. Among adults, 18 (41%) were physiologic class C or D. For the entire cohort, 9 (17%) had a moderate/severe infection, including 3 deaths (6%). After correcting for multiple comparisons, the presence of a genetic syndrome (odds ratio [OR], 35.82; P=0.0002), and in adults, physiological Stage C or D (OR, 19.38; P=0.002) were significantly associated with moderate/severe infection. Conclusions At our CHD center, the number of symptomatic patients with COVID-19 was relatively low. Patients with CHD with a genetic syndrome and adults at advanced physiological stage were at highest risk for moderate/severe infection.

Keywords: COVID‐19; adult congenital heart disease; congenital heart disease; outcomes.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Aged
  • Azithromycin / therapeutic use
  • COVID-19 / complications*
  • COVID-19 / therapy*
  • Cohort Studies
  • Female
  • Genetic Diseases, Inborn / complications
  • Heart Defects, Congenital / classification
  • Heart Defects, Congenital / complications*
  • Hospitalization / statistics & numerical data
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Intubation, Intratracheal / statistics & numerical data
  • Male
  • New York City
  • Oxygen Inhalation Therapy / statistics & numerical data
  • Retrospective Studies
  • Severity of Illness Index
  • Young Adult


  • Hydroxychloroquine
  • Azithromycin