Fitness and Sports in Children and Adolescents with Congenital Heart Defects during the COVID-19 Pandemic

Background: Physical activity is important for healthy physical and mental development in children and adolescents with congenital heart defects (CHD). The COVID-19 pandemic, which is still ongoing, had an impact on many sports activities. These often could not take place or were limited due to closures, staff shortages and group size restrictions.

Method: The aim of the study was to learn more about the nutrition and physical activity of young and adolescent CHD patients. CHD patients registered in the German National Register for Congenital Heart Defects were invited by email/post to join the study. In total, 981 patients took part and 894 patients have completed the online questionnaire (average age: 12.5 ± 3 years; 47.2% female). CHD severity: 213 simple CHD (23.8%), 338 moderate CHD (37.8%), and 343 complex CHD (38.4%). The study participants were asked to answer questions regarding nutrition, physical activity and (school) sports.

Results: Subjective fitness level at the time of the survey was rated 6.2 on a scale of 1 (very unfit) to 10 (very fit). Significant differences in subjective fitness levels were present between all three CHD severity groups (p < 0.01): simple CHD 6.8 ± 2.2; moderate CHD 6.3 ± 2.2; complex CHD 5.8 ± 2.2. For 40.7% of the respondents, the physical-sporting fitness has deteriorated during the 1st lockdown in Germany from March 2020 to May 2020 according to their own assessment (no significant differences between CHD severity groups). Also, during the 2nd lockdown in Germany starting in December 2020 until the end of April 2021, physical activity fitness status worsened in 41.5% of cases without significant influence of CHD severity. Overall, 43.8% of respondents reported doing less exercise than before the pandemic, 13.1% reported doing the same amount of exercise, and 43.1% self-reported doing more exercise than before the pandemic (no significant differences between CHD severity groups).

Conclusion: Overall, the assessment of the own fitness level of young and adolescent CHD patients CHD seems to be dependent on the CHD severity, which is also expected and thus plausible from a medical point of view. The pandemic has a major impact on the sports behavior and decreased the possibility and willingness to participate in (regular) sports. However, the pandemic affects all patients to a similar extent. In the pandemic, it has unfortunately been only partially successful so far to support and encourage young patients to do sports regularly to prevent secondary diseases.