{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T22:55:11Z","timestamp":1772751311686,"version":"3.50.1"},"reference-count":15,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:00:00Z","timestamp":1702425600000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["Greater Manchester PSRC"],"award-info":[{"award-number":["Greater Manchester PSRC"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"The British Heart Foundation","doi-asserted-by":"crossref","award":["CH\/13\/2\/30154"],"award-info":[{"award-number":["CH\/13\/2\/30154"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000274","name":"The British Heart Foundation","doi-asserted-by":"crossref","award":["RG\/F\/21\/110050"],"award-info":[{"award-number":["RG\/F\/21\/110050"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,11,1]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine the magnitude of any excess risk of mortality and hospitalisation due to COVID-19 infection in patients with congenital heart disease (CHD) in the UK healthcare system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Matched case\u2013control study within the Clinical Practice Research Datalink study of anonymised general practice records in the National Health Service in England. Patients with CHD were stratified for disease severity according to the European Society of Cardiology guidelines. Presence of a positive COVID-19 test, hospitalisation with a diagnosis of COVID-19 and COVID-19-related mortality were compared in case and control groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>86 441 patients with CHD and 335\u2009839 controls were studied. Of patients with a positive COVID-19 test, patients with CHD were more likely than controls to be hospitalised (22.4% vs 14.5%; OR=1.77 (95% CI 1.60 to 1.96); p=2.11e\u221228) and suffer COVID-19-related death (6.1% vs 3.8%; OR=1.60 (95% CI 1.35 to 1.89); p=7.00e\u221208). The excess risk of COVID-19 hospitalisation and death rose with increasing physiological severity of CHD (presence of pulmonary vascular disease and\/or cyanosis), rather than anatomical complexity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this study of the COVID-19 pandemic experience, using population health records in over 86000 patients with CHD in England, patients with CHD with COVID-19 were at around 50\u201375%\u2009higher risk of hospitalisation and mortality compared with matched controls with COVID-19. We provide the first primary care-derived estimates for COVID-19 hospitalisation and case-fatality rates in patients with CHD. Some factors predictive of worse COVID-19 outcome in general populations (such as non-white ethnic group), and other CHD-specific comorbidities (such as pulmonary hypertension), influenced outcomes among patients with CHD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002415","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T10:31:54Z","timestamp":1702549914000},"page":"e002415","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical risk associated with COVID-19 among 86000 patients with congenital heart disease"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7396-4108","authenticated-orcid":false,"given":"Simon G.","family":"Williams","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0271-0554","authenticated-orcid":false,"given":"Simon","family":"Frain","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0282-6933","authenticated-orcid":false,"given":"Hui","family":"Guo","sequence":"additional","affiliation":[{"name":"Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7336-1606","authenticated-orcid":false,"given":"Matthew J","family":"Carr","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology and Drug Safety and NIHR Greater Manchester Patient Safety Research Collaboration, The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2958-915X","authenticated-orcid":false,"given":"Darren M","family":"Ashcroft","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology and Drug Safety and NIHR Greater Manchester Patient Safety Research Collaboration, The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9573-0812","authenticated-orcid":false,"given":"Bernard D","family":"Keavney","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK"},{"name":"Manchester Heart Institute, Manchester University NHS Foundation Trust, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"2025081710394940000_10.2.e002415.1","unstructured":"UK government COVID-19 tracking website, Available: https:\/\/www.gov.uk\/government\/publications\/covid-19-track-coronavirus-cases"},{"key":"2025081710394940000_10.2.e002415.2","doi-asserted-by":"crossref","first-page":"4153","DOI":"10.1093\/eurheartj\/ehaa701","article-title":"2020 ESC Guidelines for the management of adult congenital heart disease","volume":"41","author":"Baumgartner","year":"2020","journal-title":"Eur Heart J"},{"key":"2025081710394940000_10.2.e002415.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(19)32100-X"},{"key":"2025081710394940000_10.2.e002415.4","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1016\/j.jacc.2021.02.023","article-title":"COVID-19 in adults with congenital heart disease","volume":"77","author":"Broberg","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2025081710394940000_10.2.e002415.5","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1161\/CIRCULATIONAHA.121.057833","article-title":"Critical illness among patients hospitalized with acute COVID-19 with and without congenital heart defects","volume":"145","author":"Downing","year":"2022","journal-title":"Circulation"},{"key":"2025081710394940000_10.2.e002415.6","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/apa.16588","article-title":"Congenital heart disease does not entail an increased risk for severe 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Cardiol"},{"key":"2025081710394940000_10.2.e002415.9","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2020-318467"},{"key":"2025081710394940000_10.2.e002415.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-021-02751-6"},{"key":"2025081710394940000_10.2.e002415.11","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1002\/gepi.22176","article-title":"Loss of function, missense, and intronic variants in NOTCH1 confer different risks for left ventricular outflow tract obstructive heart defects in two European cohorts","volume":"43","author":"Helle","year":"2019","journal-title":"Genet Epidemiol"},{"key":"2025081710394940000_10.2.e002415.12","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1038\/s10038-021-00976-0","article-title":"Rare GATA6 variants associated with risk of congenital heart disease phenotypes in 200,000 UK Biobank exomes","volume":"67","author":"Williams","year":"2022","journal-title":"J Hum 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