ABSTRACT
Heart transplant recipients are at a very high risk of adverse outcomes after SARS-CoV-2 infection. There is no clear guidance on how to manage immunosuppression (IS) on heart transplant patients with COVID-19;in most studies IS was decreased or held. At our center, however, we deliberately maintained IS with the premise that this would result in a reduced inflammatory response to COVID-19. In this study we present our single center experience of heart transplant recipients infected with COVID-19 in whom IS was maintained. Retrospective analysis from June 2020 to February 2022 of heart transplant recipients followed at our center that tested positive for COVID-19. Patient demographics, comorbidities, baseline IS, hospitalization, ICU need, O2 requirement, mechanical support requirement and mortality were recorded. During the study period, 581 transplants were followed at our center, we documented 65 cases of COVID-19 (Table 1). The average age was 58 years, 75% male, 51% Caucasian. 50% had DM, 69% HTN and 48% CKD. Median time since OHT was 4.6 years. 71% of the patients were on dual IS. All patients remained on their baseline immunosuppression. Of the 65 patients, 37% required hospitalization, 9% ICU-level of care. Median LOS was 5.5 days. Mortality was 8%, there were no events of rejection or allograph dysfunction. Our data suggest that maintenance of therapeutical levels of IS in patients with COVID-19 is safe in heart transplant recipients. Our outcomes were comparable to those of the existing literature. Larger studies are needed to further validate our results. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)