Abstract 15588: Effect of Covid-19 on the Mortality of Patients With Congenital Heart Disease

Introduction: Cardiovascular conditions have been recognized as risk factors for poor outcomes in association with COVID-19. However, the effect of the COVID-19 pandemic on different severity types of congenital heart disease (CHD) patients remains unknown. This study aims to examine whether patients with history of interventions for CHD experienced a higher mortality risk during the COVID-19 pandemic. Methods: This is a retrospective cohort study using data from the Pediatric Cardiac Care Consortium (PCCC). We included patients having US residence and direct identifiers, who were enrolled between 1982 and 2003 after undergoing transcatheter or surgical interventions for CHD. The observation window (2017-2020) was divided to a pre-SARSV2 and SARSV2 exposure period defined around the state specific onset of COVID-19 disease in 2020. Patients were categorized as having mild, moderate, severe-2 ventricle (2V) or single ventricle (SV) CHD. Standardized mortality ratios (SMRs) were used to describe the observed risk of mortality in CHD patients compared to the age- and sex-adjusted rates from the general U.S. population. Multivariable analysis was conducted using time-varying covariate Cox proportional hazards model with adjustment for age, sex and severity of CHD. Results: A total of 50,138 patients with history of interventions for CHD were included. Pooled pre-SARSV2 SMR was 2.38 [95% CI: 2.06, 2.75], while the SARSV2-exposure SMR was 2.07 [95% CI: 1.78, 2.35] (not significantly different). No significant differences in pooled SMRs were found by severity of CHD. The adjusted hazard risk for all-cause mortality in the SARSV2-exposure vs pre-SARSV2 period did not increase for patients with CHD (aHR: 0.59, 95%CI:0.19 - 1.84), and we did not find any differences in risk by severity subgroups or sex of patients. Conclusion: In this large cohort study monitoring long term outcomes after interventions for CHD, we could not detect any evidence of increased risk for all-cause mortality among this population during the early part of the COVID-19 pandemic. Additional data will be required over longer period to fully understand the impact of COVID-19 on adults with repaired CHD.