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Important patient information

Patient Letter of the Board of Directors

Dear patients, dear parents,

The pandemic with the new virus Covid-19/SARS-CoV-2 has changed our everyday life, with significant effects on all areas of society. The following information will be continuously updated for you.

The priority is to contain the rapid spread of the virus and to prevent an uncontrolled outbreak to ensure optimal medical care, especially for seriously ill patients. Therefore, please continue to strictly follow the current instructions and rules of the responsible federal and state authorities. Limit your contacts if possible. Make sure you strictly follow these rules: Distance, Hygiene, All-day Masks, Corona Warning App and Airing. For further information, please read "Important to know now" in this Corona Special.

Infection and Symptoms: What We Know Now so far

The coronavirus is spread from person to person. The incubation period is estimated to be 14 days. The virus can also be transmitted by people who are showing mild or no symptoms at all. The virus is transmitted largely through respiratory secretions. The infection mostly causes symptoms similar to a mild cold or the flu.

The symptoms identified as of now include, cough, temperature, shivers, headache or limb pain, a sore throat, a runny nose and the loss of the sense of taste or smell, among others. The novel strain Covid-19/SARS-CoV-2 belongs to a group of viruses that can cause severe infections of the airways, such as pneumonia. According to most recent findings, however, the virus can also affect other organs such as the heart or kidneys and can impede blood coagulation.

Accordingly, an underlying heart or lung disease, such as congenital heart disease that also affects the lungs, is considered to pose a very high risk in the case of an infection.

Mild Courses in Children and Adolescents

According to the current state of research and experience, healthy children and adolescents typically show only mild symptoms or no symptoms at all in the case of an infection with Covid-19/SARS-CoV-2. In this young patient group, the infection generally has a mild course.

This has been confirmed by publications, that are available now, resulting from studies involving several thousand children from China and US, as well as by reports from France, Spain, and England. Only in rare cases have infected children and adolescents developed pneumonia. In the majority of cases, no symptoms at all or only mild ones such as cough, a runny nose, or bronchitis were present.

  • Our Recommendation

    Daycare, School, After-school Care with mild CHD

    Attending daycare and after-school care as well as participating in school lessons are explicitly recommended for children and adolescents with mild congenital heart defects: In this young group of patients, the known positive effects of social interaction and joint learning on health and well-being outweigh the likely minor effects of a coronavirus infection.

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Risk Factors for More Severe Courses

Known risk factors for severe courses in adults include following, chronic heart disease, chronic lung disease, diabetes mellitus, and high blood pressure. There have been only case reports so far regarding the question if the situation is similar in children, adolescents and young adults with congenital heart disease.

Besides research and development of suitable drugs and vaccines, the worldwide effort continues to closely monitor the disease situation also in at-risk patients with congenital and acquired pre-existing heart or lung conditions. On this basis, the most suitable prevention and treatment measures are hoped to be identified and advanced. The current available data are not sufficient yet.

  • Our Recommendation

    Increased Vigilance for patients with Moderate to Severe CHD

    Until further notice, increased vigilance should be taken for all children, adolescents and adults with congenital heart disease that is classified as moderate to severe, just as with any other infectious disease. Contact with patients, who were tested positive for Covid-19/SARS-CoV-2 or where there is a suspicion of an infection, should be avoided. In these cases, returning to school or the workplace should be discussed ahead of time with your treating pediatric cardiologist or ACHD cardiologists, respectively, and alternative solutions should be found or applied for, if need be.

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At-Risk Groups

The group of children, adolescents and adults with congenital heart disease for whom a coronavirus infection would pose a high risk can be assumed to be comparable to the patient group for which an infection with, for instance, influenza or RS-viruses or others causing severe respiratory disease, can be threatening.

This at-risk group includes babies with heart defects that have not been corrected yet, children and adults with significantly increased or decreased pulmonary blood flow, as well as children and adults with a Fontan circulation, heart failure, or pulmonary hypertension.

The risk is particularly high in cardiac patients with a congenital immune deficiency (e.g. in cases of 22q11 or trisomy) or cardiac patients after heart transplantation or lung transplantation who are on medication impairing the immune function.

However, since Covid-19 disease occurs far less often in children and children should be protected from social isolation as far as possible, the individual risk of the child must be clarified by the treating pediatric cardiologist.

 

  • Our Recommendation

    Prevent, Check the Vaccination Status, and Slow Down the Spread

    We maintain our recommendation for affected patients, their parents and relatives to strictly adhere to the current instructions of the relevant authorities and the rules of hygiene. In addition, we also strongly recommend checking your own and your child's vaccination status. One of the general recommendations for children with congenital heart defects by the Standing Commission on Vaccination is vaccination against pneumococcus and influenza. Therefore, they are usually carried out by the treating pediatrician during regular medical checkups. There also have been cases of corona and flu infections simultaneously – reported as double infections. As pneumonia is the main complication of Covid-19/SARS-CoV infection, it is essential that the protection against pneumococcus should be checked and, if necessary, the adult patients with CHD should ensure their vaccination status is current.

    In general, just as in heart-healthy individuals, all patients with congenital heart disease should try to protect themselves from an infection in any way they can. Above all, this helps the primary goal of slowing down the spread of coronavirus.

    By clicking on the link you can read the statement of the German Society of Paediatric Cardiology (DGPK)

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We Will Keep You Updated

Dear patients and parents,

we wish you a good time despite Corona. Should new findings lead to a changed state of knowledge in the next days and weeks, we will inform you immediately. 

Please stay healthy and confident!

Yours,

Board of Directors of the Competence Network for Congenital Heart Defects

Prof. Dr. med. Hashim Abdul-Khaliq
Chair and Speaker of the Management Board

Prof. Dr. med. Helmut Baumgartner
Deputy Chair of the Management Board

Prof. Dr. med. Christian Schlensak
Deputy Chair of the Management Board

Dr. med. Ulrike Bauer
Managing Director

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