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Clin Transplant ; 34(12): e14091, 2020 12.
Article in English | MEDLINE | ID: covidwho-772451

ABSTRACT

A chronic immunosuppressed state as in solid organ transplant recipients is a reported risk factor for the novel 2019 coronavirus infection. Patients with a history of orthotopic heart transplant (OHT) at a tertiary care transplant center in Detroit, Michigan were retrospectively reviewed from March until May 2020. Clinical parameters and outcomes of 5 OHT recipients and one combined heart-lung recipient with confirmed SARS-CoV-2 were obtained. The cohort was predominately African American males with median age of 59 years (interquartile range, 48.25-73.25). All patients were classified as having mild-moderate disease; none required intubation or ICU admission with no deaths. The most common presenting symptoms were fever and shortness of breath 83% (n = 5), followed by cough and chills 67% (n = 4). All admitted patients (n = 5) received hydroxychloroquine and 3 received high-dose steroids. Antimetabolites were held for 2 patients (33.3%). The calcineurin inhibitor trough goal was decreased in only 1 patient; 3 other patients, without change in goal, required calcineurin inhibitor dosage reduction. Two patients requiring readmission presented 7 and 23 days after initial symptoms onset. In conclusion, our experience with OHT patients infected by the SARS-CoV-2 virus did not have an elevated risk of severe infection. Impact of modifying immunosuppression remains unclear.


Subject(s)
COVID-19/immunology , Heart Transplantation , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Postoperative Complications/immunology , Adult , Aged , COVID-19/diagnosis , COVID-19/etiology , COVID-19/therapy , COVID-19 Testing , Combined Modality Therapy , Female , Graft Rejection/prevention & control , Hospitalization , Humans , Immunosuppressive Agents/therapeutic use , Male , Michigan , Middle Aged , Postoperative Complications/diagnosis , Postoperative Complications/therapy , Postoperative Complications/virology , Retrospective Studies , Severity of Illness Index , Treatment Outcome
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