Q&A Coronavirus English

Over the past few weeks, we’ve received a very large number of questions about the coronavirus (COVID-19) and the effects it may have on heartchildren. A single Facebook post even generated over 150 questions. As a result, Hartekind has taken the initiative to organize a C-team together with the pediatric cardiology department. The C-team consists of pediatric cardiologists from all pediatric heart centers in the Netherlands, who discuss and formulate answers for the most frequently asked questions in a Q&A.

The main goal of this Q&A is to create an approachable source of information for heartchildren and their parents, and to provide unambiguous answers for everyone in the Netherlands. It is important to note that all answers are based on the guidelines formulated by the Netherlands National Institute for Public Health and the Environment (RIVM) and the Dutch Association of Pediatrics (NVK). These guidelines are changing continually, and we will attempt to translate them to what they mean for heartchildren. Every week, on Monday, the new questions and answers appear in this Q&A.

Above all, together we must ensure that we stop the spread of the coronavirus. So, KEEP A SAFE DISTANCE, DO NOT SHAKE HANDS, WASH YOUR HANDS REGULARLY, COUGH IN YOUR ELBOW, USE PAPER TISSUES and STAY AT HOME IF YOU HAVE SYMPTOMS.

If you have a question for the C-team yourself, please send an email to info@hartekind.nl.

It is important that all questions are generic in nature, focusing on the heartchild target group. Each heartchild is unique. Therefore, if you have questions that are specific to your child, please ask your doctor. No rights may be derived from these answers, and they serve as an approachable source of information for heartchildren and their parents.

Note: the following pediatric cardiologists, all from pediatric heart centers in the Netherlands, are in the C-team: Annelies van der Hulst, Arno Roest, Beatrijs Bartelds, Gabrielle van Iperen, Gideon du Marchie Sarvaas and Regina Bokenkamp

Do heartchildren fall under the coronavirus risk group?

The coronavirus causes symptoms related to a cold. There are very many cold viruses, and luckily we now know that this coronavirus (COVID-19) only lightly effects children, much like other viruses that cause a cold. Most heartchildren can handle a cold or a fever well.


However, there is always a certain group of heartchildren that is more vulnerable to the flu and/or respiratory diseases. The group of vulnerable heartchildren consists of:

- Children with a single ventricle heart / Fontan circulation

- Children younger than 1 years old, who still need surgery or cardiac catheterization (like VSD, AVSD, Tetralogy of Fallot)

- Children with cyanosis (with saturation continuously under 85%)

- Children with cardiomyopathy and/or heart failure (for which they have medication)

- Children with pulmonary hypertension

- Children who have had a heart transplant

- Children who, besides their heart defect, also suffer from severe lung and/or kidney problems.


It is always essential to keep a close eye on them when they have a cold or are sick. This often blows over on its own, just like this coronavirus. But if their cold becomes more severe or they experience tightness in their chest, their pediatric cardiologist should be contacted. For every heartchild and especially every child in the group listed above, the advice is to adhere to the guidelines stated by the RIVM, by, for instance, washing your hands well and maintaining 1.5 meters distance between yourself and others.


Are heartchildren more likely to be infected by the coronavirus?

No, heartchildren are not more likely than other children to be infected by the coronavirus or develop the disease. The advice is to adhere to the RIVM’s guidelines, just like everyone else.


My heartchild had a flu shot, does that help against the coronavirus?

No, flu shots protect against other viruses, unfortunately not against the coronavirus. People are working on a vaccine, though as of now, it seems the development of that vaccine is going to take a while.


Do heartchildren get the coronavirus more quickly than others?

No, heartchildren do not get the coronavirus more quickly than others. The advice is to adhere to the RIVM’s guidelines, just like everyone else.


Are you more at risk if you have a donor valve?

You are not more likely to be infected with the coronavirus or to develop the disease than other children. As far as we know now, the coronavirus only mildly affects children (cold symptoms/mild flu symptoms). This does not appear to have a different effect on children with donor valves.


Say you are a heartchild and you are infected with the coronavirus, is the chance you will die higher than with a child that does not have a heart defect?

Currently, taking into account Italy and China, we can see that children are less at risk of becoming severely ill from the coronavirus than, for instance, elderly people and adults with underlying severe conditions. If a child is infected with the virus, the effects are often relatively mild. As of yet, we have no reason to believe the virus affects heartchildren any differently. If you fall under the group of more vulnerable heartchildren (listed in question 1), you are advised to contact your pediatric cardiologist in case of more severe cold symptoms or tightness in the chest area. Each heartchild is advised to adhere to the RIVM’s guidelines, by, for instance, washing their hands well and maintaining 1.5 meters distance between themselves and others.


Say your heartchild is infected with the coronavirus and is in the ICU or the nursing department, can you be with your child or is there a 1 hour per day limit and must you stay 2 meters away, just like with adults?

This varies among all hospitals. It depends on the protocol that is being upheld at the hospital. In general, the hospitals are very strict when it comes to coronavirus patients in the ICU, guests are not allowed. Different rules may apply for other departments, however.


Playing outside with friends? Visiting child care facilities, schools?

 -Are heartchildren still allowed to go outside and play with their friends?

- Is my heartchild allowed to play outside?

- Are my heartchild’s siblings still allowed to play outside?

- Can my heartchild go back to school when the schools reopen?

- As parents, we work in vital professions. Can we bring our heartchild to a child care facility?

- Can I bring my heartchild to his or her babysitter/day care?


The answer to all of these questions is based on a balance between what is allowed and what is possible,

The government and the  have provided clear advice on keeping a safe distance and limiting the number of contacts to prevent infection with and transfer of the virus. Thus, being in contact with many people increases the chance of transfer. This means you should try to limit the number of people you are in contact with. 

Within a family, this is not really possible, but outside of a family, it is. Consequently, it is sensible to limit the number of children you are in contact with. Limiting visits by your friends to a minimum (1 or maybe 2) is therefore very sensible. The same goes for your siblings’ friends. Make sure that the friends that come over do not have a cold.


Playing outside is good, due to the usually large physical distance.  Very intensive physical contact between children who are playing outside is discouraged. You also need to be mindful about playing on public playing equipment, due to possible infected surfaces. So, be sure to wash your hands well after playing! The challenge is to think of some new types of games to play outside.


The RIVM says the following concerning the matter: “Children up to and including the age of 12 playing together under the supervision of one or more parents or guardians is not considered as group formation. Provided that the parents and/or guardians maintain 1.5 meters distance between one another.


Visiting child care facilities should be a good option, provided that everyone abides by the advice given by the government. That could become more difficult if the number of children in one location is larger.  If your child is in one of the more vulnerable categories (listed above), you may want to consider making an alternative decision. Be careful with grandparents operating as babysitters. They are more vulnerable than the children.  Visiting a school, child care facility or daycare should be possible if the government estimates this is safe again. The timing considering this issue is still uncertain.