COVID-19: Implications for children and adults with congenital heart disease

We do not currently have a lot of information about COVID-19 infection in children and adults with congenital heart disease and outcomes. However, based on what is known, we think some patients may be at higher risk of complications. In addition to social distancing, personal hygiene and other measures recommended at KYCOVID19.ky.gov, there are some extra steps children and adults with congenital heart disease (CHD) can take to stay healthy.

Patients who may be at higher risk for serious illness from coronavirus include:

  • Single ventricle patients, such as those with hypoplastic left heart syndrome, pulmonary atresia and tricuspid atresia, or patients who have had a Norwood, Blalock-Taussig (BT) shunt, Glenn, or Fontan procedure
  • Patients with heterotaxy syndrome (where the heart may be on the right side of the body or the spleen may be absent)
  • Pulmonary hypertension patients
  • Patients with congenital heart disease who are due to have surgery in the near future
  • Patients with other chronic illnesses or medical conditions (such as lung disease, kidney disease, Down syndrome, trisomy 18, trisomy 13, etc.)
  • Patients with severe Kawasaki disease requiring treatment with special medications that suppress the immune system
  • Heart transplant patients
  • Patients with heart failure or cardiomyopathy where there is decreased heart function causing symptoms or limiting activity

Patients who have had previous heart surgery with good results, are not taking any heart medications, have been cleared to participate in normal activities or don’t fit into the high-risk categories above should follow basic prevention guidelines.

What high-risk CHD patients should do

  • Make sure you have enough medications and medical supplies.
  • Take everyday precautions to keep space between yourself and others.
  • When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
  • Avoid crowds as much as possible.
  • During a COVID-19 outbreak in your community, stay home as much as possible to further reduce the risk of being exposed.

Travel

  • Avoid cruise travel and nonessential air travel.
  • International travel is discouraged.
  • Travel within the United States should be undertaken with caution and is discouraged in high risk patients.
  • Should patients need to travel, strongly consider taking additional essential medicines with you to ensure you have a sustainable supply in the event of an unexpected quarantine or travel delay.

Face masks

  • It is not clear if wearing a mask at home or in the community will help prevent infection.
  • The best prevention is avoidance of crowds and sick individuals.
  • Neither the Norton Children’s Heart Institute, affiliated with UofL School of Medicine, nor the Centers for Disease Control and Prevention (CDC) is recommending the use of masks for infection protection outside the hospital at this time.

Work/school guidance

  • Avoid working jobs with significant exposure to large numbers or groups of people (i.e., retail establishments, coffee shops, restaurants).
  • Individuals in the health-care field should consult with their employers about steps to take to protect themselves.
  • CHD patients, particularly high-risk patients, are encouraged to work from home if possible.
  • If a family has concerns about attendance at school (when schools reopen) or work attendance, they should contact the patient’s physician for individual recommendations or excuse letters.

Norton Children’s Heart Institute

Contact your health care provider or Norton Children’s Heart Institute with additional questions.

(502) 629-2929

What should I do if I have flu-like/respiratory symptoms?

  • There are many different causes for fever, cough, shortness of breath and flu-like symptoms.
  • Currently, in North America, influenza and several other respiratory viruses are circulating as well.
  • If you believe you have COVID-19 based on your travel or contact history, or if there is a community spread of COVID-19, call your physician for further instructions. If you have a cough or fever and access to a mask, place a surgical mask on when in public to avoid the spread of infection to anyone else.
  • If you have only mild symptoms your physician may not want you to come to the clinic, so talk with your doctor FIRST before coming to a hospital or clinic.

What should I do if a family member/co-worker is diagnosed with COVID-19?

  • If a close contact is diagnosed with or suspected of having COVID-19, you should avoid the person, monitor for symptoms, and contact your physician if you develop fever, cough or shortness of breath.

COVID-19

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