Figure 3.

Data from approximately 100 000 patients affected in Northern Italy illustrating that, in general, severe COVID-19 and death are linked to advanced patient age. Most ACHD patients are young²⁸ in contrast, and this would suggest a lower risk. However, in this dataset the majority of non-congenital patients with COVID-19 who died had one or more (mainly cardiovascular) comorbidities. This suggests that pre-existing cardiac involvement (as seen in ACHD) is a major risk factor for adverse outcome (Dataset Minichini, Kaggle, based on Italian Civil Protection Department data, 21 April 2020). On balance, therefore, the net effect of these contradicting factors on ACHD outcome are currently unclear. ACHD, adult congenital heart disease; CHD, congenital heart disease.