Effect of COVID-19 on congenital heart disease children: a literature review

Mahmoud Ibrahim Ali, Hisham Fayiz Alkhuzaie, Saleh Abbas Alhashim, Hadeel Abdulhameed Hassan, Amal Hassan Tawhari, Mariam Ali Al Aqili, Ahmad Khaled Abdulqader, Mohamed Sadek Hegaze, Saleh Mahdi Alturkistani, Abdulrahman Muneer Hameed, Aishah Ahmad Radin, Mlouk Bassam Shabrawishi, Shrouq Abdulaziz Almadani


Congenital heart diseases are the most common birth defects and have variable levels of severity. Some studies showed that CHD increases the odds of COVID-19 realted complications; however, others suggested that there is no such a correlation. Due to the aforementioned lack of evidence, we aim in this review to provide a comprehensive overview of the impact of COVID-19 infection on CHD patients. For that, an extensive literature search of Medline, Cochrane, and EMBASE databases was performed using the medical subject headings or a combination of all possible related terms. Patients diagnosed with both CHD and COVID-19 infection has reported that CHD patients, especially those with a genetic syndrome, are at high risk to develop moderate to severe symptoms. Moreover, CHD surgeries were postponed or even canceled, with a decline in overall admission days, due to hospital protocol or pateints’ decisions. Also, the findings suggested that congenital heart surgeries can be safely done during the pandemic when there is case volume limitation, with the safety precautions are followed by both surgical staff and patients. In conclusion, the scarce evidence along with the variety in CHD types and their different clinical presentations; makes it hard to predict the outcomes and to manage CHD-COVID-19 co-morbid children. More studies are needed to guide management plans in this particular context.


COVID-19, Congenital heart diseases, Impact, Effect, Surgeries

Full Text:



Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020 Feb 20;382(8):727-33.

Radke RM, Frenzel T, Baumgartner H, Diller GP. Adult congenital heart disease and the COVID-19 pandemic. Heart. 2020;106(17):1302-9.

Zu ZY, Jiang MD, Xu PP. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiol. 2020;296(2):E15-25.

Shi Y, Wang G, Cai X-P. An overview of COVID-19. J Zhejiang Univ Sci. 2020;21(5):343-60.

Gallego P, Ruperti-Repilado FJ, Schwerzmann M. Adults with congenital heart disease during the coronavirus disease 2019 (COVID-19) pandemic: are they at risk?. Rev Esp Cardiol. 2020;73(10):795-8.

Alsaied T, Aboulhosn JA, Cotts TB. Coronavirus Disease 2019 (COVID-19) Pandemic implications in pediatric and adult congenital heart disease. J Am Heart Assoc. 2020;9(12):e017224.

Guan WJ, Liang WH, Zhao Y. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Resp J. 2020;55(5).

Guzik TJ, Mohiddin SA, Dimarco A. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020;116(10):1666-87.

Brida M, Chessa M, Gu H, Gatzoulis MA. The globe on the spotlight: Coronavirus disease 2019 (Covid-19). Int J Cardiol. 2020;310:170-2.

Giordano R, Cantinotti M. Congenital heart disease in the era of COVID-19 pandemic. Gen Thorac Cardiovasc Surg. 2020:1-3.

Stephens EH, Dearani JA, Guleserian KJ. COVID-19: Crisis management in congenital heart surgery. Ann Thorac Surg. 2020;110(2):701-6.

Wu W, He J, Shao X. Incidence and mortality trend of congenital heart disease at the global, regional, and national level, 1990-2017. Medicine. 2020;99 (23):e20593.

Yu CM, Wong RSM, Wu EB. Cardiovascular complications of severe acute respiratory syndrome. Postgrad Med J. 2006;82(964):140-4.

Gilca R, De Serres G, Boulianne N. Risk factors for hospitalization and severe outcomes of 2009 pandemic H1N1 influenza in Quebec, Canada. Influenza Other Respir Viruses. 2011;5(4):247-55.

Haiduc AA, Ogunjimi M, Shammus R. COVID-19 and congenital heart disease: an insight of pathophysiology and associated risks. Cardiol young. 2020:1-8.

Bertoncelli D, Guidarini M, Della Greca A, Ratti C, Falcinella F, Iovane B, Dutto ML, Caffarelli C, Tchana B. COVID19: potential cardiovascular issues in pediatric patients. Acta Biomed. 2020;91(2):177-83.

Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55(5):1169-74.

Lewis MJ, Anderson BR, Fremed M, et al. The Impact of coronavirus disease 2019 (covid-19) on patients with congenital heart disease across the lifespan: the experience of an academic congenital heart disease center in New York city. J Am Heart Assoc. 2020:e017580.

Sabatino J, Ferrero P, Chessa M. COVID-19 and Congenital heart disease: results from a nationwide survey. J Clin Med. 2020;9(6).

Goldshtrom N, Vargas D, Vasquez A, Kim F, Desai K, Turner ME, et al. Neonates With Complex Cardiac Malformation and Congenital Diaphragmatic Hernia Born to SARS-CoV-2 Positive Women-A Single Center Experience. World J Pediatr Congenit Heart Surg. 2020;11(6):697-703.

Wojcik BM, Rajab TK, Newman S, Jaggers J, Mitchell MB. COVID-19 testing, surgical prioritization, and reactivation in a congenital cardiac surgery program. World J Pediatr Congen Heart Surg. 2020:2150135120967012.

Korun O, Yurdakök O, Arslan A, Çiçek M, Selçuk A, Kılıç Y, Altın F, Şaşmazel A, Aydemir NA. The impact of COVID-19 pandemic on congenital heart surgery practice: An alarming change in demographics. J Card Surg. 2020;35(11):2908-12.

Giamberti A, Varrica A, Agati S. Impact of the coronavirus disease 2019 (COVID-19) pandemic on the Italian congenital cardiac surgery system: a national survey. Eur J Cardio-Thorac Surg. 2020;58 (6):1254-60.

Zheng F, Liao C, Fan Q-H. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci. 2020;40(2):275-80.

Bernier PL, Stefanescu A, Samoukovic G, Tchervenkov CI. The challenge of congenital heart disease worldwide: epidemiologic and demographic facts. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2010;13(1):26-34.

Hubbard R, Latham GJ, Zabala LM, Gautam NK. The COVID-19 Crisis and its impact on congenital cardiac surgery charitable endeavors. Paediatr Anaesth. 2020;30(8):956-7.

El-Saiedi SA, Haeffele C, Hanna BM, Lui GK. The hidden victims of the COVID-19 pandemic: congenital heart disease patients. JACC Case Rep. 2020;2(9):1411-3.

Marino L, Wagland R, Culliford D, Bharucha T, Sodergren S, Darlington A-S. No official help is available - experience of parents and children with congenital heart disease during COVID-19. MedRxiv. 2020.

Hemphill NM, Kuan MTY, Harris KC. Reduced physical activity during COVID-19 pandemic in children with congenital heart disease. Can J Cardiol. 2020;36(7):1130-4.

Eghbali A, Shokrollahi S, Mahdavi NS, Mahdavi SA, Dabbagh A. COVID-19 in pediatric patients: A case series. J Cell Amp. 2020;5(1):3-5.

Linnane N, Cox DW, James A. A case of COVID-19 in a patient with a univentricular heart post total cavopulmonary connection (Fontan) surgery. Cardiol Young. 2020;30(9):1350-2.

Elbehery M, Munshi FA, Alzahrani A, Bakhsh M, Alariefy M. COVID-19 in an intrauterine growth restriction (iugr) infant with congenital heart disease: case report and literature review. Cureus. 2020;12(9): e10294.

Kohli U, Rosebush JC, Orlov NM, Ghavam A. COVID-19 pneumonia in an infant with a hemodynamically significant ventricular septal defect. Cardiol Young. 2020:1-3.

Bezerra RF, Franchi SM, Khader H, Castro RM, Liguori GR, da Fonseca da Silva L, et al. COVID-19 as a confounding factor in a child submitted to staged surgical palliation of hypoplastic left heart syndrome: One of the first reports of SARS-CoV-2 infection in patients with congenital heart disease. J Thorac Cardiovasc Surg. 2020;S0022-5223(20):31317-9.

Krishnan US, Krishnan SS, Jain S. SARS-CoV-2 infection in patients with down syndrome, congenital heart disease, and pulmonary hypertension: is down syndrome a risk factor?. J Pediatr. 2020;225:246-8.

Rodriguez Z, Shane AL, Verkerke H, et al. COVID-19 convalescent plasma clears SARS-CoV-2 refractory to remdesivir in an infant with congenital heart disease. Blood advances. 2020;4(18):4278-4281.

Simpson M, Collins C, Nash DB, Panesar LE, Oster ME. Coronavirus Disease 2019 Infection in Children with Pre-Existing Heart Disease. J Pediatr. 2020;227: 302-7.