{"doi":"10.4103/apc.apc_134_21","title":"Outcome of COVID-19-positive children with heart disease and grown-ups with congenital heart disease","abstract":"<jats:sec>\n            <jats:title>Background :</jats:title>\n            <jats:p>Outcome data of children with heart disease who acquired COVID-19 infection are limited.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Aims :</jats:title>\n            <jats:p>We sought to analyze outcome data and identify risk factors associated with mortality in children with heart disease and grown-ups with congenital heart disease (GUCH) who had a laboratory-confirmed COVID-19 infection.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Settings and Design :</jats:title>\n            <jats:p>This is a retrospective, multicentric, observational study.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Materials and Methods :</jats:title>\n            <jats:p>The study included children with heart disease and GUCH population, who presented with either symptomatic or asymptomatic COVID-19 infection to any of the participating centers. COVID-19-negative patients admitted to these centers constituted the control group.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Results :</jats:title>\n            <jats:p>From 24 pediatric cardiac centers across India, we included 94 patients with a median age of 12.5 (interquartile range 3–96) months and 49 (52.1%) patients were males. Majority (83 patients, 88.3%) were children. One-third of the patients (<jats:italic toggle=\"yes\">n</jats:italic> = 31, 33.0%) had acyanotic congenital heart disease, and 41.5% (<jats:italic toggle=\"yes\">n</jats:italic> = 39) were cyanotic, with &gt; 80% of the patients being unoperated. Only 30 (31.9%) patients were symptomatic for COVID-19 infection, while the rest were incidentally detected positive on screening. A total of 13 patients died (case fatality rate: 13.8%). The in-hospital mortality rate among hospitalized patients was significantly higher among COVID-19-positive cases (13 of 48; 27.1%) as compared to COVID-negative admissions (9.2%) during the study period (<jats:italic toggle=\"yes\">P</jats:italic> &lt; 0.001). On multivariate analysis, the independent predictors of mortality among COVID-19-positive cases were severity of illness at admission (odds ratio [OR]: 535.7, 95% confidence interval [CI]: 6.9–41,605, <jats:italic toggle=\"yes\">P</jats:italic> = 0.005) and lower socioeconomic class (OR: 29.5, 95% CI: 1.1–814.7, <jats:italic toggle=\"yes\">P</jats:italic> = 0.046).</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions :</jats:title>\n            <jats:p>Children with heart disease are at a higher risk of death when they acquire COVID-19 infection. Systematic preventive measures and management strategies are needed for improving the outcomes.</jats:p>\n          </jats:sec>","journal":"Annals of Pediatric Cardiology","year":2021,"id":630356,"datarank":0.5533319181170905,"base_score":3.6888794541139363,"endowment":3.6888794541139363,"self_citation_contribution":0.5533319181170905,"citation_network_contribution":0.0,"self_endowment_contribution":0.5533319181170905,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":39,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1632981,"name":"Sivasubramanian Ramakrishnan","orcid":null,"position":1,"is_corresponding":false},{"id":1632982,"name":"Mrigank Choubey","orcid":null,"position":2,"is_corresponding":false},{"id":1632983,"name":"Nageswara Rao Koneti","orcid":null,"position":3,"is_corresponding":false},{"id":1632984,"name":"Kalaivani Mani","orcid":null,"position":4,"is_corresponding":false},{"id":1632985,"name":"Shweta Bakhru","orcid":null,"position":5,"is_corresponding":false},{"id":1444195,"name":"Saurabh Kumar Gupta","orcid":null,"position":6,"is_corresponding":false},{"id":1632987,"name":"Debasree Gangopadhyay","orcid":null,"position":7,"is_corresponding":false},{"id":1632988,"name":"Soumya Kasturi","orcid":null,"position":8,"is_corresponding":false},{"id":1632990,"name":"Jayashree Mishra","orcid":null,"position":9,"is_corresponding":false},{"id":1632992,"name":"Hemant Kumar Nayak","orcid":null,"position":10,"is_corresponding":false},{"id":1632993,"name":"Kothandam Sivakumar","orcid":null,"position":11,"is_corresponding":false},{"id":1632994,"name":"Prashant Bobhate","orcid":null,"position":12,"is_corresponding":false},{"id":1632996,"name":"Neeraj Awasthy","orcid":null,"position":13,"is_corresponding":false},{"id":187002,"name":"Debasis Das","orcid":"0000-0001-8967-3348","position":14,"is_corresponding":false},{"id":1632999,"name":"Manisha Chakrabarti","orcid":null,"position":15,"is_corresponding":false},{"id":1633000,"name":"Chinnaswamy Sivaprakasam Muthukumaran","orcid":null,"position":16,"is_corresponding":false},{"id":1633003,"name":"Rajan Saileela","orcid":null,"position":17,"is_corresponding":false},{"id":1633005,"name":"Bhargavi Dhulipudi","orcid":null,"position":18,"is_corresponding":false},{"id":1633008,"name":"Shiv Kumar Chaudhary","orcid":null,"position":19,"is_corresponding":false},{"id":1633010,"name":"Mahimarangaiah Jayranganath","orcid":null,"position":20,"is_corresponding":false},{"id":1633011,"name":"Anita Saxena","orcid":null,"position":21,"is_corresponding":false},{"id":1494119,"name":"Krishna Subramony Iyer","orcid":"0000-0003-0561-0257","position":22,"is_corresponding":false},{"id":1633012,"name":"Raman Krishna Kumar","orcid":null,"position":23,"is_corresponding":false},{"id":1633014,"name":"Shyam S Kothari","orcid":null,"position":24,"is_corresponding":false},{"id":1633016,"name":"Snehal Kulkarni","orcid":null,"position":25,"is_corresponding":false},{"id":1633018,"name":"Suresh G Rao","orcid":null,"position":26,"is_corresponding":false},{"id":1632980,"name":"Sakshi Sachdeva","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Outcome of COVID-19-positive children with heart disease and grown-ups with congenital heart disease","abstract":"<jats:sec>\n            <jats:title>Background :</jats:title>\n            <jats:p>Outcome data of children with heart disease who acquired COVID-19 infection are limited.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Aims :</jats:title>\n            <jats:p>We sought to analyze outcome data and identify risk factors associated with mortality in children with heart disease and grown-ups with congenital heart disease (GUCH) who had a laboratory-confirmed COVID-19 infection.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Settings and Design :</jats:title>\n            <jats:p>This is a retrospective, multicentric, observational study.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Materials and Methods :</jats:title>\n            <jats:p>The study included children with heart disease and GUCH population, who presented with either symptomatic or asymptomatic COVID-19 infection to any of the participating centers. COVID-19-negative patients admitted to these centers constituted the control group.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Results :</jats:title>\n            <jats:p>From 24 pediatric cardiac centers across India, we included 94 patients with a median age of 12.5 (interquartile range 3–96) months and 49 (52.1%) patients were males. Majority (83 patients, 88.3%) were children. One-third of the patients (<jats:italic toggle=\"yes\">n</jats:italic> = 31, 33.0%) had acyanotic congenital heart disease, and 41.5% (<jats:italic toggle=\"yes\">n</jats:italic> = 39) were cyanotic, with &gt; 80% of the patients being unoperated. Only 30 (31.9%) patients were symptomatic for COVID-19 infection, while the rest were incidentally detected positive on screening. A total of 13 patients died (case fatality rate: 13.8%). The in-hospital mortality rate among hospitalized patients was significantly higher among COVID-19-positive cases (13 of 48; 27.1%) as compared to COVID-negative admissions (9.2%) during the study period (<jats:italic toggle=\"yes\">P</jats:italic> &lt; 0.001). On multivariate analysis, the independent predictors of mortality among COVID-19-positive cases were severity of illness at admission (odds ratio [OR]: 535.7, 95% confidence interval [CI]: 6.9–41,605, <jats:italic toggle=\"yes\">P</jats:italic> = 0.005) and lower socioeconomic class (OR: 29.5, 95% CI: 1.1–814.7, <jats:italic toggle=\"yes\">P</jats:italic> = 0.046).</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions :</jats:title>\n            <jats:p>Children with heart disease are at a higher risk of death when they acquire COVID-19 infection. Systematic preventive measures and management strategies are needed for improving the outcomes.</jats:p>\n          </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"34667396","pmcid":"PMC8457291","openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by-nc-sa","oa_locations":[{"url":"https://doi.org/10.4103/apc.apc_134_21","host_type":"publisher"},{"url":"https://journals.lww.com/10.4103/apc.apc_134_21","host_type":"publisher"},{"url":"https://doaj.org/article/18dcb228e9b7483ca97dd6517224afb7","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/8457291","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC8457291","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC8457291?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":[],"mesh_terms":[],"keywords":["Congenital heart disease","Surgery","Outcome","Grown-ups With Congenital Heart Disease","Low- And Middle-Income Countries And Sars-Cov-2 Infection"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-05T21:04:34.601481Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}