Friday, March 31, 2023
Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™
ABIM Diplomates - maximum of 0.25 ABIM MOC points
Nurses - 0.25 ANCC Contact Hour(s) (0 contact hours are in the area of pharmacology)
Pharmacists - 0.25 Knowledge-based ACPE (0.025 CEUs)
Physician Assistant - 0.25 AAPA hour(s) of Category I credit
IPCE - 0.25 Interprofessional Continuing Education (IPCE) credit
This activity is intended for cardiologists, critical care clinicians, infectious disease clinicians, internal medicine clinicians, nurses, pharmacists, physician assistants, and other members of the healthcare team for patients with congenital heart defects (CHDs) who may be at risk for severe COVID-19.
The goal of this activity is that learners will be better able to describe the period prevalence of critical COVID-19 illness (intensive care unit admission, invasive mechanical ventilation, or death) among hospitalized patients with COVID-19 with and without CHDs, and characteristics associated with critical COVID-19 illness among patients with CHDs, according to an analysis of data on inpatient encounters from March 2020 through January 2021 from the Premier Healthcare Database Special COVID-19 Release, an all-payor database representing ≈ 20% of US hospital admissions.
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CME / ABIM MOC / CE Released: 4/15/2022
Valid for credit through: 4/15/2023
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Note: The information on the coronavirus outbreak is continually evolving. The content within this activity serves as a historical reference to the information that was available at the time of this publication. We continue to add to the collection of activities on this subject as new information becomes available. It is the policy of Medscape Education to avoid the mention of brand names or specific manufacturers in accredited educational activities. However, manufacturer names related to COVID-19 vaccines may be provided in this activity to promote clarity. The use of manufacturer names should not be viewed as an endorsement by Medscape of any specific product or manufacturer.
Several clinical factors, including heart disease, increase risk for severe COVID-19 illness. The association of congenital heart defects (CHDs) with such risk among adults is unclear. A recent study which analyzed data from patients hospitalized with COVID-19 compared those with and without CHDs to provide additional evidence to support COVID-19 mitigation strategies such as social distancing and vaccinations. This study also identified the need for further studies that factor in social, economic, and other disparities that may influence COVID-19 outcomes for patients with CHDs. Additionally, more data is still needed for the role of specific comorbidities in severe COVID-19 illness to help guide members of the healthcare team when caring for the most critically ill and vulnerable patients.
Adults with CHDs are at increased risk for serious illness and death when hospitalized with COVID-19, making vaccination and other preventive measures even important in this population, said researchers with the Centers for Disease Control and Prevention (CDC).
"We found that hospitalized patients with heart defects are up to twice as likely to have critical outcomes of COVID-19 illness (admission to the intensive care unit [ICU], use of a ventilator to help with breathing, or death) compared to hospitalized COVID-19 patients without heart defects," Karrie Downing, MPH, epidemiologist, with the CDC’s National Center on Birth Defects and Developmental Disabilities, told theheart.org | Medscape Cardiology.
"Additionally, we learned that people with hearts defects who were older or who also had other conditions like heart failure, pulmonary hypertension, Down syndrome, diabetes, or obesity were the most likely to have critical COVID-19 illness, but children and adults with heart defects without these other conditions were still at increased risk," Downing said.
The message for healthcare providers is clear: "Encourage your patients with heart defects to get vaccinated and discuss with your patients the need for other preventive measures to avoid infection that may progress to severe COVID-19 illness," Downing added.
The study was published online March 7 in Circulation.
The researchers analyzed data on 235,638 patients hospitalized with COVID-19 between March 2020 and January 2021, including 421 (0.2%) with CHDs.
Most patients with CHDs were aged 30 years or older (73%), and 61% were men, with 55% non-Hispanic White, 20% Hispanic, and 16% non-Hispanic Black.
Overall, 68% of patients with CHDs had at least 1 comorbidity, as did 59% of patients without CHDs.
Rates of ICU admission were higher in the CHD group (54% vs 43%), as were rates of invasive mechanical ventilation (IMV) (24% vs 15%) and in-hospital death (11% vs 7%).
After accounting for patient characteristics, ICU admission, IMV, and death were more prevalent among patients with COVID-19 with rather than without CHDs, with adjusted prevalence ratios (aPRs) of 1.4, 1.8 and 2, respectively.
When stratified by high-risk characteristics, prevalence estimates for ICU admission, IMV, and death remained higher among patients with COVID-19 and CHDs across nearly all strata, including younger age groups and persons without heart failure, pulmonary hypertension, Down syndrome, diabetes, or obesity, the researchers reported.
Downing said more work is needed to identify why the clinical course of COVID-19 disease results in admission to the ICU, the need for a ventilator, or death for some hospitalized patients with CHDs and not for others.
"There could be a number of social, environmental, economic, medical, and genetic factors playing a role. But staying up to date with COVID-19 vaccines and following preventive measures for COVID-19 are effective ways to reduce the risk of severe illness from COVID-19," Downing said.
The study had no specific funding. The authors report no relevant disclosures.
Circulation.Published online March 7, 2022.[1]
