Year : 2021 | Volume
: 14 | Issue : 4 | Page : 566--567
COVID-19 and pediatric cardiac care in India: Time to take stock
Department of Cardiology, SCTIMST, Trivandrum, Kerala, India
Department of Cardiology, SCTIMST, Trivandrum, Kerala
|How to cite this article:|
Sasikumar D. COVID-19 and pediatric cardiac care in India: Time to take stock.Ann Pediatr Card 2021;14:566-567
|How to cite this URL:|
Sasikumar D. COVID-19 and pediatric cardiac care in India: Time to take stock. Ann Pediatr Card [serial online] 2021 [cited 2022 Jul 3 ];14:566-567
Available from: https://www.annalspc.com/text.asp?2021/14/4/566/340930
I read with great interest the two multicenter studies on the impact of COVID-19 on congenital heart disease (CHD). I heartily congratulate the authors on the initiative to gather data from multiple institutions spread across the country. It is concerning to note that outpatient visits and hospitalizations for CHD dipped low during the pandemic and continued to remain so even after admission rates for acute coronary syndromes stabilized. As the authors mention, this could indicate the relatively less number of specialized pediatric cardiac care centers in the country and the logistics of transporting sick children to these centres due to the restricted mobility during the pandemic. It is quite likely that the actual mortality figures for the CHD population is higher during the pandemic years because a significant number would not have come to the attention of medical community at all. The reported more than 70% reduction in hospitalizations and the alarmingly same trend in neonatal admissions, as well as emergency surgeries, are indicators that this missed group of patients might have died or are very sick, requiring emergency medical attention. The time delay in procedures caused by the pandemic may be very costly in certain interventions like pulmonary artery banding. This study covered the initial period of the pandemic, but we are not much wiser after more than a year of waxing and waning COVID-19 cases. The onus of further management should be on devising strategies to provide adequate transportation facilities for critical heart diseases even amidst regional lockdowns. As there is no immediate end to the pandemic, ways have to be devised to provide timely care to elective and semi-elective cases also, that is, life should get back as close to normalcy as possible. The prolongation of the hypoxic environment due to the one or 2-year delay in repairing stable cyanotic heart diseases may have long-term effects on the growth of these young children.
The overall low number of COVID infections in children might explain the less lung involvement in the present study. However, the picture may be different in the second wave or worse in the predicted third wave. The data on the effect of COVID-19 infection on children with CHD have shown an increased mortality, especially in the untreated. This rightly points out that emergency care should continue to be offered to COVID-infected babies.
Our country has unique geographic, socioeconomic, and demographic hurdles which make it difficult to extrapolate data from other countries for application in our system. The “research made in India” initiative suggested by the pediatric cardiac society of india (PCSI) aims at encouraging research on questions pertinent to India and the most relevant topic still continues to be the effect of the pandemic on various aspects of cardiac care. As we have now crossed the second wave of the pandemic, we should think of a epilogue to this study conducted during the first wave when clinicians and patients alike were naïve to the multitude of effects of the SARS-COVID virus. This will give us insight as to how physicians and surgeons have learned to live with the ongoing pandemic and identify if the lacunae identified in the first wave still exists in pediatric cardiac care.
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Conflicts of interest
There are no conflicts of interest.
|1||Choubey M, Ramakrishnan S, Sachdeva S, Mani K, Gangopadhyay D, Sivakumar K, et al. Impact of COVID-19 pandemic on pediatric cardiac services in India. Ann Pediatr Card 2021;14:260-8.|
|2||Sachdeva S, Ramakrishnan S, Choubey M, Koneti NR, Mani K, Bakhru S, et al. Outcome of COVID-19-positive children with heart disease and grown-ups with congenital heart disease: A multicentric study from India. Ann Pediatr Card 2021;14:269-77.|