Kanigiri Sendzikaite, S., Heying, R., Milanesi, O., Hanseus, K., & Michel-Behnke, I.
healingly The COVID-19 pandemic has had a huge influence in almost all areas of life, affecting societies, economics, and health care systems worldwide. The paediatric cardiology community is no exception. As the challenging battle with COVID-19 continues, professionals from the Association for the European Paediatric and Congenital Cardiology receive many questions regarding COVID-19 in a Paediatric and Congenital Cardiology setting. The aim of this paper is to present the AEPC position on frequently asked questions based on the most recent scientific data, as well as to frame a discussion on how to take care of our patients during this unprecedented crisis. As the times are changing quickly and information regarding COVID-19 is very dynamic, continuous collection of evidence will help guide constructive decision-making.
how to order clomid online The paper by Sendzikaite and coworkers  reflects the position of the Association for the European Pediatric and Congenital Cardiology (AEPC) on frequently asked questions relating to COVID-19 in a Pediatric and Congenital Cardiology setting. The questions addressed cover varied themes but probably the most vexing relates to which patients with congenital heart defect (CHD) are most vulnerable to COVID-19 and are most likely to suffer death or require intensive care unit admission. The AEPC’s position is based on recommendations of the British Congenital Cardiac Association  published in March 2020. Those recommendations may be clarified further using new data obtained from adults with CHD. From 58 adult CHD centers, Broberg and coworkers  reported on 1,044 infected patients, 87% of whom had laboratory-confirmed COVID-19 infection. There were 24 COVID-related deaths (case fatality: 2.3%). In this cohort of adults with CHD, the authors showed that whilst COVID-19 mortality in adults with CHD was similar to that of the general population, the most vulnerable patients were those with worse physiological stage (e.g., cyanosis and pulmonary hypertension; p=0.001); anatomic complexity alone did not predict infection severity.  Although these findings were obtained from adults with CHD, other studies in children have shown that severe CHD associated with hypoxemia and refractory end-organ dysfunction confers increased vulnerability to the effects of COVID-19 infection. [4, 5]
cheapest cytotec It is intuitive and also evident from the paper of Sendzikaite and coworkers  that evolving research will be needed to help guide evidence-based decision making in managing CHD patients in the setting of COVID-19. The rapidly evolving situation with this pandemic means that what may be considered evidence today may very well be unsubstantiated tomorrow.
- Sendzikaite S, Heying R, Milanesi O, Hanseus K, Michel-Behnke I. COVID-19 FAQs in paediatric and congenital cardiology: AEPC position paper. Cardiol Young. 2021 Mar;31(3):344-351.
- British Congenital Cardiac Association. COVID-19 (Corona Virus): Vulnerable groups with congenital heart disease. Published March 18th, 2020. Available at https://www.pediatriccardiaclearningcenter.org/guidelines/covid19/british-congenital-cardiac-association-2020.pdf Accessed May 3rd, 2021.
- Broberg CS, Kovacs AH, Sadeghi S, et al. COVID-19 in Adults With Congenital Heart Disease. J Am Coll Cardiol. 2021;77(13):1644-1655.
- Haji Esmaeil Memar E, Pourakbari B, Gorgi M, et al. COVID-19 and congenital heart disease: a case series of nine children. World J Pediatr. 2021;17(1):71-78.
- Alsaied T, Aboulhosn JA, Cotts TB, Daniels CJ, Etheridge SP, Feltes TF, Gurvitz MZ, Lewin MB, Oster ME, Saidi A. Coronavirus Disease 2019 (COVID-19) Pandemic Implications in Pediatric and Adult Congenital Heart Disease. J Am Heart Assoc. 2020 Jun 16; 9(12):e017224