Kids with heart conditions prone to severe COVID-19Congenital and acquired heart conditions such as biventricular defects, cardiac arrest, and heart failure are associated with increased COVID-19 severity in US children, suggests a multicenter study published yesterday in JAMA Network Open.Researchers from Children's Health of Orange County in California led the retrospective study of 171,416 US children 2 months to 17 years old who tested positive for COVID-19 and had a history of 1 of 26 studied heart conditions.The patients were seen at 85 health systems from Mar 1, 2020, to Jan 31, 2021.
Their heart conditions had been identified from Jan 1, 2015, to Dec 31, 2019. Median age was 8 years, half were boys, and 10% had severe COVID-19.Of all patients, 64% were White, 44.4% were Hispanic or Latino, 14.5% were Black, 1.6% were Asian or Pacific Islander, 1.4% were American Indian or Alaska Native, and 18.5% were of mixed, other, or unknown race.The likelihood of severe COVID-19 among patients with heart conditions was elevated: cardiac arrest (odds ratio [OR], 9.9); cardiogenic shock (OR, 3.1); heart surgery (OR, 3.0); cardiopulmonary disease (OR, 1.9); heart failure (OR, 1.8); low blood pressure (OR, 1.6); nontraumatic cerebral hemorrhage (OR, 1.5); pericarditis (OR, 1.5); simple biventricular defects (OR, 1.5); venous embolism and thrombosis (OR, 1.4); complex biventricular defects (OR, 1.3); and essential high blood pressure (OR, 1.2).A total of 194 of 258 patients (75.2%) with a history of cardiac arrest were younger than 12 years.
Of these patients, 79.5% had severe COVID-19, and 27.9% died. Also, 5.0% of patients required oxygen via a nasal cannula, 0.1% received bilevel or continuous positive airway pressure, 6.7%