Schwerzmann, MarkusRuperti-Repilado, Francisco JavierBaumgartner, HelmutBouma, BertoBouchardy, JudithBudts, WernerCampens, LaurenceChessa, MassimoDel-Cerro-Marin, Maria JesusGabriel, HaraldGallego, PastoraGarcia-Orta, RocioGonzalez, Ana ElviraSchophuus-Jensen, AnnetteLadouceur, MagalieMiranda-Barrio, BertaMorissens, MariellePasquet, AgnesRueda, Joaquinvan-den-Bosch, Annemien Evan-der-Zwaan, Heleen BerdinaTobler, DanielGreutmann, Matthias2023-02-092023-02-092021-03-08Schwerzmann M, Ruperti-Repilado FJ, Baumgartner H, Bouma B, Bouchardy J, Budts W, et al. Clinical outcome of COVID-19 in patients with adult congenital heart disease. Heart. 2021 Jul 12;107(15):1226-1232.http://hdl.handle.net/10668/17330Patients with adult congenital heart disease (ACHD) are a potentially vulnerable patient cohort in case of COVID-19. Some cardiac defects may be associated with a poor COVID-19 outcome. Risk estimation in ACHD is currently based on expert opinion. The aim of this study was to collect clinical outcome data and to identify risk factors for a complicated course of COVID-19 in patients with ACHD. Twenty-five ACHD centres in nine European countries participated in the study. Consecutive patients with ACHD diagnosed with COVID-19 presenting to one of the participating centres between 27 March and 6 June 2020 were included. A complicated disease course was defined as hospitalisation for COVID-19 requiring non-invasive or invasive ventilation and/or inotropic support, or a fatal outcome. Of 105 patients with a mean age of 38±13 years (58% women), 13 had a complicated disease course, of whom 5 died. In univariable analysis, age (OR 1.3, 95% CI 1.1 to 1.7, per 5 years), ≥2 comorbidities (OR 7.1, 95% CI 2.1 to 24.5), body mass index of >25 kg/m2 (OR 7.2, 95% CI 1.9 to 28.3) and cyanotic heart disease (OR 13.2, 95% CI 2.5 to 68.4) were associated with a complicated disease course. In a multivariable logistic regression model, cyanotic heart disease was the most important predictor (OR 60.0, 95% CI 7.6 to 474.0). Among patients with ACHD, general risk factors (age, obesity and multiple comorbidities) are associated with an increased risk of complicated COVID-19 course. Congenital cardiac defects at particularly high risk were cyanotic lesions, including unrepaired cyanotic defects or Eisenmenger syndrome.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/congenitalheart defectsChild, PreschoolHeart Defects, CongenitaEisenmenger ComplexBody Mass IndexNoninvasive VentilationCOVID-19Obesityresearch article33685931open accessPacientesEnfermedadRiesgoCardiopatíasObesidadComplejo de EisenmengerVentilación10.1136/heartjnl-2020-3184671468-201XPMC7944416https://heart.bmj.com/content/heartjnl/107/15/1226.full.pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944416/pdf