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Canadian Congenital Heart Alliance

COVID-19 and CHD Research

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December 12, 2020  Postion paper from the ESC working group of Adult Congenital Heart Disease and the International Society for Adult Congenital Heart Disease.published in Eurpoean Heart Journal. https://doi.org/10.1093/eurheartj/ehaa960

The paper discusses the broad impact of COVID-19 on ACHD patients, focusing specifically on pathophysiology, risk stratification for work, self-isolation, hospitalization, impact on pregnancy, psychosocial health, and longer-term implications for the provision of ACHD care. 

Figure 1 illustrated the non-ACHD risk factors and as well as categorizes risk for ACHD

Risk stratification of patients according to anatomical and physiological condition   

Table 1 outlines recommendations for work/education according to patient risk category

General considerations regarding work/education

Low-risk ACHD patients

   Usual protection measures recommended 

   Follow general recommendations (face mask, etc.) 

   No general limitation for work/school

Moderate-risk ACHD patients

   Individualized risk assessment. General recommendations: 

     - Reduce non-essential contact with public/clients/students/colleagues 

     - Discuss workplace protective measures (face mask/PPE)

High-risk ACHD patients

   Meticulous physical distancing

   Avoidance of direct contact to clients or students whenever possible. Preference for home office work

 

Adequate immunization status (influenza/pneumococcal disease) is recommended, specifically mentioning patients with Down syndrome, univentricular hearts, asplenia, cyanotic congenital heart disease, 22q11 syndrome and other conditions with compromised immune system. 

Figure 2 provides an oveview of management guidelines for ACHD patients with suspected COVID-19

  Overview over general management principles recommended for adult congenital heart disease patients

with Table 2 identifing vulnerable ACHD sub-cohorts and the specific management considerations and pertinent pathophysiological characteristics

Univentricular heart—including Fontan palliation

PAH

Eisenmenger physiology (shares all aspects with cyanotic conditions)

Cyanotic conditions

Systemic RV

Patients with Down syndrome 

The paper discourages collapsing all patients with ACHD into the one broad category with adults with acquired cardiovascula disease for risk of complications from COVID-19 and recognizes that social isolation, psychological distress and the avoidance of medical care can have devestating impacts. 

For full details and recommendations, please read the full article at https://doi.org/10.1093/eurheartj/ehaa960

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October 8, 2020  Data released from an International Society for Adult Congenital Heart Disease and American Congenital Heart Association supported international patient registry on #COVID19 outcomes in people with ACHD, presented at the 30th International Symposium on October 8, 2020.

Recent registry data shows 4.4% COVID-related death rate and 8.9% COVID-related complication rate

General findings from COVID-19 and CHD registry

Significant univariate associations with COVID-related death:

  • older age
  • diabetes
  • baseline cyanosis/hypoxemia
  • prior arrhythmia or CHF
  • worse NYHA functional class
  • heavier weight
  • renal disease
  • pulmonary hypertension
  • higher RV systolic pressure
  • higher BNP prior to infection

Significant univariate associations with COVID-related death in ACHD

Similar associations for COVID-related complications

Significant univariate associations with COVID-related complications in ACHD

Anatomic classification does not appear to be associated with adverse outcomes in the #ACHD cohort, but physiologic classification does. You can refer to details of anatomic/physiologic classification in Table 4 from the 2018 ACHD guidelines here: https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000000603

Conclusions from COVID-19 and CHD registry study

Congratulations to study investigators Dr. Jamil Aboulhosn, Dr. Adrienne Kovacs and Dr. Craig Broberg, as well as all contributing centers and investigators!

International contributing centers and investigators

Thank you to International Society for Adult Congenital Heart Disease for providing this summary from the ISACHD Symposium 2020 @IntlACHD

 

Visit our COVID-19 and CHD information page for health information and Tips infographic for those living with CHD

Visit our COVID-19 Wellness and Activities Resources page for fun activities and resources for families

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Every year, Statistics Canada collects data from hundreds of surveys. As the amount of data gathered increases, Statistics Canada has introduced infographics to help people, business owners, academics, and management at all levels, understand key information derived from the data. Infographics can be used to quickly communicate a message, to simplify the presentation of large amounts of data, to see data patterns and relationships, and to monitor changes in variables over time.

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StatsCan: The impact of the COVID-19 pandemic on Canadian families and children

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StatsCan: How are Canadians with long-term conditions and disabilities impacted by the COVID-19 pandemic

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StatsCan: Activities and concerns of Canadian youth during the COVID-19 pandemic

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To see the full list of infographics available on variety of topics, visit Statistics Canada Infographics

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Chaque année, Statistique Canada recueille des données dans le cadre de centaines d'enquêtes. Comme le nombre de données recueillies augmente, Statistique Canada a mis au point des infographies pour aider les particuliers, les entrepreneurs, les universitaires et les gestionnaires à tous les niveaux à comprendre l'information clé tirée des données. Les infographies peuvent être utilisées pour communiquer rapidement un message, simplifier la présentation de grandes quantités de données, déterminer les tendances et les rapports dans les données et surveiller les changements dans les variables au fil du temps.

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StatistiquesCan: La santé mentale des Canadiens pendant la pandémie de COVID-19

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StatistiquesCan: Quelles sont les répercussions de la COVID-19 sur les Canadiens ayant un problème de santé de longue durée ou une incapacité

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StatistiquesCan: Activités et inquiétudes des jeunes Canadiens pendant la pandémie de COVID-19

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Pour voir la liste complète des infographies disponibles sur divers sujets, visitez Infographie de Statistique Canada

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