Medicine and Healthcare
The Risk Factor Viral Pneumonia
Clinical Course in Patients with Congenital Heart Defects
Scientific name of the study
Mortality and Morbidity in Patients with Congenital Heart Disease Hospitalized for Viral Pneumonia
The lives of patients with congenital heart defects have changed in recent decades. Medical, surgical, and catheter-interventional progress enables most of those affected to live significantly longer and largely unimpaired by the underlying disease. Even though many are reaching retirement age today, they are not cured.
Heart failure, cardiac arrhythmia, lung diseases, neurological as well as kidney and liver diseases are among the most frequent complications in patients with moderate to severe congenital heart defects. There is significant risk of developing myocarditis or endocarditis and dying. More than 30 percent of adult patients with moderate to severe heart defects suffer from at least moderately impaired lung function.
Consequently, severe viral pneumonia is more life-threatening for patients with congenital heart defects than for patients without congenital heart defects. How high the risk actually is, was determined for the first time by the research group around the cardiologist and EMAH specialist Gerhard-Paul Diller of the University Hospital Münster in the context of a broad study in co-operation with the Barmer health insurance. The long-term course of a total of 24,980 patients requiring inpatient treatment was studied.
Flu Vaccination Is a Survival Factor
According to the study, young and middle-aged patients with congenital heart defects show similarly frequent severe disease progressions and fatalities as those observed in heart-healthy patients over the age 60. The researchers determined that the complexity of the congenital heart defect, chromosomal anomalies, heart medication, the use of immunosuppressive drugs as well as the absence of flu protection are central risk factors.
"This shows how important an appropriate vaccination is, even if it does not provide one hundred percent protection. We can only strongly advise each individual patient to check his or her vaccination status and, if necessary, to be vaccinated against both influenza and pneumococcal pneumonia. This is all the more important against the background of the COVID-19 pandemic," says Gerhard-Paul Diller.
Good to know
Check Influenza Protection, Avoid Double Infections
The worldwide spread of the virus COVID-19/SARS-CoV-2 endangers above all patients at risk and elderly. In addition to strict adherence to the AHA rules, distance, hygiene measures, and all-day masks, it is particularly important for high-risk patients with congenital heart defects to avoid possible double infections. Both the influenza vaccination and the vaccination against pneumococcus should be immediately checked and, if necessary, carried out.collapse
Patients with Moderate and Severe Heart Defects Belong To the High-Risk Group
This investigation, which involved a study period from 2005 to 2018, showed that even young patients with more complex congenital heart defects upon becoming infected with viral pneumonia required artificial ventilation as frequently as, and died as frequently as, older patients aged 60 and over who did not have congenital heart defects. With the exception of patients who have a mild congenital heart defect without further organ changes, from the researchers’ point of view, AHF patients with severe viral pneumonia are clearly among the high-risk patients who need special protection against infection with COVID-19.
Scientific Details of the Study
Learn more about the study design, material and methods, as well as the background of the study:
Mortality and morbidity in patients with congenital heart disease hospitalised for viral pneumonia.
Diller GP, Enders D, Lammers AE, Orwat S, Schmidt R, Radke RM, Gerss J, De Torres Alba F, Kaleschke G, Bauer UM, Marschall U, Baumgartner H
Heart (British Cardiac Society) 107, 13, 1069-1076, (2020). Show this publication on PubMed.