| アブストラクト | OBJECTIVE: To determine the magnitude of any excess risk of mortality and hospitalisation due to COVID-19 infection in patients with congenital heart disease (CHD) in the UK healthcare system. METHODS: Matched case-control study within the Clinical Practice Research Datalink study of anonymised general practice records in the National Health Service in England. Patients with CHD were stratified for disease severity according to the European Society of Cardiology guidelines. Presence of a positive COVID-19 test, hospitalisation with a diagnosis of COVID-19 and COVID-19-related mortality were compared in case and control groups. RESULTS: 86 441 patients with CHD and 335 839 controls were studied. Of patients with a positive COVID-19 test, patients with CHD were more likely than controls to be hospitalised (22.4% vs 14.5%; OR=1.77 (95% CI 1.60 to 1.96); p=2.11e-28) and suffer COVID-19-related death (6.1% vs 3.8%; OR=1.60 (95% CI 1.35 to 1.89); p=7.00e-08). The excess risk of COVID-19 hospitalisation and death rose with increasing physiological severity of CHD (presence of pulmonary vascular disease and/or cyanosis), rather than anatomical complexity. CONCLUSIONS: In this study of the COVID-19 pandemic experience, using population health records in over 86000 patients with CHD in England, patients with CHD with COVID-19 were at around 50-75% higher risk of hospitalisation and mortality compared with matched controls with COVID-19. We provide the first primary care-derived estimates for COVID-19 hospitalisation and case-fatality rates in patients with CHD. Some factors predictive of worse COVID-19 outcome in general populations (such as non-white ethnic group), and other CHD-specific comorbidities (such as pulmonary hypertension), influenced outcomes among patients with CHD. |
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| 組織名 | Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of;Biology, Medicine and Health, Manchester Academic Health Science Centre, The;University of Manchester, Manchester, UK.;Division of Population Health, Health Services Research and Primary Care, School;of Health Sciences, Faculty of Biology, Medicine and Health, The University of;Manchester, Manchester, UK.;Centre for Pharmacoepidemiology and Drug Safety and NIHR Greater Manchester;Patient Safety Research Collaboration, The University of Manchester, Manchester,;UK.;University of Manchester, Manchester, UK bernard.keavney@manchester.ac.uk.;Manchester Heart Institute, Manchester University NHS Foundation Trust,;Manchester, UK. |
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