TY - JOUR T1 - Pediatric and congenital heart disease during the COVID-19 pandemic: the triple threat JF - World Journal of Pediatric Surgery JO - World Jnl Ped Surgery DO - 10.1136/wjps-2021-000299 VL - 4 IS - 2 SP - e000299 AU - Salem T Argaw AU - Maryam S Babar AU - Dominique Vervoort Y1 - 2021/05/01 UR - http://wjps.bmj.com/content/4/2/e000299.abstract N2 - The COVID-19 pandemic has left an unprecedented mark on the world. As of April 2021, over 100 million people have been confirmed with COVID-19, leading to nearly 3 million deaths—and counting.1 Children have been found to present with less severe COVID-19 symptoms than adults, with less than 1 death in 500 pediatric cases.2 However, despite early assumptions that children’s role in transmission was minimal, data suggest novel SARS-CoV-2 variants are more infective among children and may be important drivers of community spread.3 Based on recent developments, the pandemic poses a triple threat to the pediatric and congenital heart disease (PCHD) burden as a result of COVID-19 infection and the collateral damage of the pandemic. This, inevitably, will have major socioeconomic implications at the individual and population levels.In the present article, we review the triple threat of the COVID-19 pandemic on the PCHD burden, concluding with opportunities to respond to the global burden of PCHD during and beyond the pandemic.The global burden of PCHD is substantial as more than seven million children live with cardiovascular disease.4 Congenital heart defects (CHDs) are the most common major congenital anomaly, affecting one in every hundred live births; yet CHD has been largely neglected on the global public health agenda.5 In upper middle-income and high-income countries, CHD has become a more obvious leading cause of under-5 mortality due to improvements in infectious disease care and other child health services.6 In low-income and lower middle-income countries (LMICs), the prognosis for a child born with CHD is significantly worse compared with children born with CHD in high-income countries, and CHD will proceed to play an increasing role in infant mortality as a result of the epidemiological transition away from communicable diseases.5 Global disparities in access to care have … ER -