COVID-19 in children with congenital heart disease in Asia: clinical features and recommendations for management

Abstract

Globally, around 1.35 million children are born with a congenital heart disease’s every year. Making CHDs one of the world's most common congenital anomaly and, thus, a significant global health issue. The CHD prevalence rate is highest in Asia (9.3 per 1000 live births) which is followed by Europe (8.2 per 1000 live births) and lowest in Africa (1.9 per 1000 live births). The existing high CHD burden on pediatric health infrastructures around the world has been worsened due to the global coronavirus (COVID-19) pandemic. Approximately, a total of 22.9 million children and adolescent cases of COVID-19 have been recorded. The highest infectivity rate has been in children under 3 years of age.3 90% of reported pediatric cases have been categorized as mild or moderate disease, 5.2% as severe and 0.6% as critical.4 Over 12,300 children and adolescents have died due to COVID-19. Of these deaths, 58% have occurred in the 10-19 age group and 42% in the 0-9 age group. Which can prove to be exceedingly detrimental in Low to Middle Income regions, such as Asia, where the medical infrastructure is less robust and usually poorly accessible. According to a systematic review on the association of COVID-19 and pediatric co-morbidities, around 5.1% of severely ill children have had an underlying comorbidity, such as CHD. However, at present, the data from Asia is very limited. There are only a handful of large, observational cohort studies. These have been conducted primarily in China, Iran, and India.