key: cord-0890700-wkp70b6x
authors: Fusco, Flavia; Scognamiglio, Giancarlo; Merola, Assunta; Palma, Michela; Correra, Anna; Borrelli, Nunzia; Barracano, Rosaria; Grimaldi, Nicola; Colonna, Diego; Romeo, Emanuele; Sarubbi, Berardo
title: Coronavirus disease 2019 in patients with Fontan circulation
date: 2021-03-31
journal: International journal of cardiology. Congenital heart disease
DOI: 10.1016/j.ijcchd.2021.100126
sha: f97a4b2fa0241659772377d5892d95c5dcbddbe6
doc_id: 890700
cord_uid: wkp70b6x

nan

Dear Editor, early data during the current pandemic demonstrated worse outcome in patients with pre-existing heart disease 1 . Consequently, adults with congenital heart disease (ACHD) have been deemed at high risk of adverse outcome from Covid-19, particularly those with complex anatomy 2 . We would like to report our experience with Coronavirus disease 2019(Covid-19) among patients with Fontan circulation at our ACHD tertiary centre.

We retrospectively included all Fontan patients who were infected from the beginning of the To the best of our knowledge, this is the first European report of Covid-19 in Fontan circulation.

Surprisingly, in our cohort no one presented severe manifestations from Covid-19. Our data are in line with the positive outcome described in 10 Fontan patients in a single-centre US study 6 . These results may be partially explained with the observation that, despite the above-described multiple implications of Covid-19, patients with single-ventricle might be protected by younger age, patients' education to self-isolation and chronic treatment with anticoagulants/antiplatelets, which were showed to improve the outcome 7, 8 . Interestingly, according to the 2018 ACC/AHA ACHD guidelines 9 , 6 out of 7 patients in our study had an advanced physiological stage, which was reported as a risk factor of adverse outcome in ACHD patients 5 . Patients with failing Fontan or unstable haemodynamics may be at higher risk of complications from Covid-19. In our cohort, patient 7 was recently admitted for acute heart failure and had undergone abdominal surgery for hemoperitoneum following ovarian cyst rupture, which was complicated by acute kidney injury requiring dialysis shortly before contracting Covid-19.

After 1-year of observation, we found a relatively low rate of infection among our Fontan patients.

The effects of our stringent preventive policy, which has already described elsewhere 10 , might have protected ACHD patients from exposure. However, due to the small number of cases, the real F igure L egend

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