# The Impact of Acute COVID-19 Infection and Long COVID in Patients with Congenital Heart Disease: A Longitudinal Study by the German National Register for Congenital Heart Disease

## TL;DR

This study finds that most CHD patients had mild to moderate acute COVID-19, but a higher rate of long-term symptoms compared to the general population.

## Contribution

The study provides longitudinal insights into acute and long-term effects of COVID-19 in a national cohort of CHD patients.

## Key findings

- Most CHD patients experienced mild to moderate acute COVID-19, with no deaths reported.
- 31% of CHD patients reported long COVID symptoms, higher than the general population.
- Hospitalization was rare, even among patients with complex or cyanotic CHD.

## Abstract

Background: Patients with congenital heart disease (CHD) were considered to belong to a vulnerable group at risk for COVID-19 infection. Our aim was to investigate the severity of acute COVID-19 infection in this patient group as well as the occurrence of sequelae. Methods: We performed telephone interviews with all accessible COVID positive CHD patients from our online COVID-19 patient survey. Baseline information was extracted from our nationwide data bank, with further details from hospital discharge letters. Results: Ninety-nine patients (or parents) were interviewed (male 50.5%): 28 children, 32 young adults (up to 29 years), and 39 adults (30 years and above). Twenty patients had simple, 38 moderate, and 41 complex CHD (10.1% were cyanotic). In twelve patients the CHD was native, ten underwent univentricular palliation, and the rest had corrective cardiac treatment. Thirty patients had additional non-cardiac risk factors. The acute course of COVID-19 was mild in 50, moderate in 38, and severe in three patients, requiring hospitalization. No deaths occurred. Long COVID symptoms (persisting ≥ 12 weeks) were reported by 31 patients. Conclusions: Despite underlying CHD, the severity of the acute course of COVID-19 in our cohort is comparable to that in the general population. Even patients with cyanotic CHD, complex CHD after univentricular palliation, or those with pulmonary hypertension, usually had a mild to moderate course, so that hospitalization was rarely necessary. The percentage of CHD patients reporting Long COVID symptoms (31%) was higher than in the general population. The long-term impact of COVID-19 and Long COVID in CHD patients is unknown and remains to be investigated.