COVID-19 and Congenital Heart Disease: Perspectives From a Resource-limited Setting
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COVID-19 and Congenital Heart Disease: Perspectives From a Resource-limited Setting
have to be weighed on case-to-case basis. Factors which need to be focused upon include resource utilization, such as anticipated ventilator duration, and ICU stay; clinical status of the patient and risk of delaying intervention, and; risk of exposure for the patient, family, and healthcare staff [8]. During the current situation, where healthcare personnel are themselves contracting the disease, optimal timings for congenital heart surgery [9] may not be practical.
Due to the emerging nature of the coronavirus disease (COVID-19), its effect on children/adults with congenital heart disease (CHD) are yet unknown. In developed countries, the majority of patients undergo effective surgical and/or catheter interventions in childhood. Thus, only a small proportion of patients have residual defects, and may be more prone to COVID-19 complications [1]. However, in a country like India, where large numbers of patients either remain unoperated or are just palliated, there is a possibility that severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection may be detrimental to such patients. Not only the risk of SARS-CoV-2 infection may be higher as compared to age-matched controls, the additive burden of COVID-19 can further compromise the facilities in already scarce cardiac care programs [2]. The categories of pediatric patients with cardiac disease, likely to be at a higher risk of severe COVID-19 disease are: cyanotic congenital heart disease with pulmonary artery hypertension (PAH) or severe cyanosis (SpO2
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