The risk of Covid-19/SARS-CoV-2 infection depends on the diagnosis of the congenital heart defect in you or your child and on the age of the patient. As a general rule, please consult your paediatric cardiologist or GUCH specialist.

The following risk groups apply to GUCH patients. For children, an individual assessment by the paediatric cardiologist must be taken, as children generally have a low risk of contracting Covid-19.

There is a low risk of congenital heart defects with normal heart function and normal ventricle size, if neither arrhythmia nor pulmonary hypertension (pulmonary hypertension) is present. This also applies in the context of a minmal residual shunt, mild valve leakage (insufficiency) or obstruction (stenosis).

There is a high risk in single-chamber hearts, fontan circulation, cyanotic heart lesions, in severe valvar stenoses or insufficiency as well as in severe ventricular dysfunction, and/or pulmonary hypertension.

High risk also applies to syndromes with immunodeficiency, malfunction or absence of the spleen (heterotaxy syndromes), and for transplanted patients. All patients who are not included in the low or high risk group are considered to have a moderate risk.

Please also read the following for additional information.

Please continue having your routine check-ups to prevent a potential deterioration of your state of health in time.

Please contact your treating physician, paediatric cardiologist, or ACHD cardiologists immediately by phone or e-mail if you or your child experience breathing difficulties, cardiac symptoms, a reduced exercise capacity, and/or heart rhythm irregularities.

Please do not discontinue any prescribed medication at your own discretion; make sure to consult your treating physician first. Please contact your treating physician, paediatric cardiologist, or ACHD cardiologists also regarding questions about other diseases or specific risks for your child with a congenital heart disease or yourself, if you are affected.

Do not visit a medical practice, hospital, or outpatient clinic without giving advance notice. Make sure to give advance notice and obtain confirmation by phone before keeping scheduled appointments. In addition, please refer to the respective websites of hospitals and medical practices for the most recent information.

The vaccination status should be complete, especially for patients with congenital heart defects. Cases of corona and influenza infections simultaneously have also been reported as double infections.

As pneumonia caused by Covid-19/SARS-CoV-2 is the main complication, it is important to check the vaccination status against pneumococcus. Vaccination against pneumococcus and influenza is one of the vaccinations generally recommended by the Standing Commission on Vaccination, regardless of corona. Therefore, it is normally administered to children with congenital heart defects as part of the routine check-ups by your pediatrician.

Patients with congenital heart defects should always check their vaccination status and have the important vaccinations up-to-date.

No. In principal, outdoor activities, as well as attending school, are absolutely recommended for children with mild congenital heart disease. In patients with moderate to severe heart defects, however, the treating paediatric cardiologist should be consulted anyhow. In these cases, the individual risk has to be assessed for each patient and, if necessary, alternative ways of schooling have to be considered.

Relevant questions regarding social law have been answered by the Bundesverband Herzkranke Kinder e. V. (Federal association of heart-children; BVHK), among others.

The thoughts mentioned above apply to children, adolescents and adults with congenital heart disease. Adults with congenital heart disease or parents of patients with congenital heart disease, who work at medical institutions, care facilities, day care centers, schools or other community facilities, where the general risk of getting infected is higher, are urgently recommended to consult their treating cardiologist; in addition, they should check with their employer regarding sufficient infection protection measures at their workplace and discuss if there are any alternative work tasks with a more effective infection protection.

In the case of jobs that involve (short) contact to many people, e.g. in the retail sector, the food service industry or in the public transportation sector, the recommended sanitary measures should be adhered to at any time to protect yourself and/or family members with an increased risk.

Relevant questions regarding social law have been answered by the Bundesverband Herzkranke Kinder e. V. (Federal association of heart-children; BVHK), among others.

Should you notice typical symptoms in yourself or your child and/or have a reasonable cause to suspect an infection, for instance after having had contact with an infected person, please avoid direct contact with any additional people and refrain from using public transportation as well as waiting areas/rooms.

Please do not visit a medical practice, hospital or outpatient clinic without giving advance notice. Contact your primary care physician or your pediatrician by phone. Many cities and communities have mobile medical teams for administering the tests.

In the case of a suspected corona infection, patients with moderate and severe congenital heart defects should in addition always be seen by a paediatric cardiologist or an ACHD cardiologists, depending on their clinical state.

Hotline

For general information, as well as personal advice on the coronavirus, please contact the patient service of the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung) at the number 116 117.

Following the distancing and hygiene regulations is the most important and most effective protection from getting infected. In practice, this means keeping a distance of at least 1.5 to 2 meters, washing your hands thoroughly and repeatedly, observing the cough and sneeze regulations, and self-isolation in the case of an infection.
In addition, all-day masks are indispensable especially now in the colder season. Namely when several people meet in closed rooms and stay there longer (e.g. at school or at work) as well as everywhere where a distance of at least 1.5 meters to other people is not always guaranteed (e.g. in stores, on public transport, but also outdoors).

Wearing a community mask or a surgical mask cannot, however, replace the described protective measures. This particular measure only helps protecting others. It reduces the risk of transmitting the infection to others by coughing, sneezing or talking and can thus help slowing down the spread of the virus. There is no sufficient scientific proof that a community mask or a surgical mask protects oneself from getting infected (self-protection).

In addition, handling such a protective cover/mask correctly is of vital importance. The mask has to be placed tightly over the mouth and the nose and it has to be replaced once it is soaked. While wearing it, you must not touch or adjust it and you must also not wear it around your neck. The correct care of the mask is equally important. After being used once, masks should be washed at 95 degrees (Celsius), if possible, or at 60 degrees at the very least. After being washed, they have to be dried completely.

You can find further important information on the correct use and care of nose and mouth masks at the Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM).

Please also read all complete information from the Robert Koch Institute (RKI).

Apart from case reports, there are no reliable data so far regarding the question of whether Fontan patients with severe congenital heart disease involving the lung have an increased risk of getting infected with the coronavirus. However, a severe disease course in these patients has to be assumed in case of an infection.

In principle, a Covid-19 infection with a severe course involving pneumonia can be treated with ventilation therapy, as it does in other patients. However, due to these patients’ specifics, this therapy should be provided by centers that are experienced in treating congenital heart disease.