ABSTRACT
The pandemic caused by SARS-CoV-2 is resulting in hospitalizations and increased mortality worldwide. Given the potentially high prevalence and severity of COVID-19 in heart transplant recipients, there is a great need for data in this high-risk cohort. Here, we report our experience with the outcomes and management of heart transplant recipients infected with SARS-CoV-2 at a German transplant center across recent pandemic waves. All adult patients who had received heart transplantation at our center and who were confirmed to have COVID-19 infection between 12/2020 and 07/2022 (n = 48) were included and retrospectively characterized. The mean age was 60.5 (46.3-63.8) years, and the majority were male (83%). The hospitalization rate was 83%, while comorbidities included diabetes (31%), arterial hypertension (73%) and chronic renal failure (90%). 90% of all SARS-CoV-2-positive HTx patients were infected since the start of our vaccination campaign (03/2021), while of those 43 patients, 88% were fully vaccinated at the time of infection (vaccine breakthrough). The median time from vaccination to infection in these patients was 138 (85-225) days. Antiviral therapy was administered in 83% of all cases, and passive immunization (convalescent plasma/monoclonal antibodies) was given in 98% of all cases. Oxygen administration was required in 10% of patients;only one patient required noninvasive ventilation (2%), and no patient required invasive ventilation or mechanical cardiovascular support (ECMO). No new cardiovascular or thromboembolic events were noted, and we observed no COVID-19-associated mortality. With increasing number of vaccinated patients and treatment options, we did not detect severe courses or increased mortality of COVID-19 in heart transplant recipients. Prospective studies are needed to provide better prognostic assessments of COVID-19 in (heart) transplanted patients in the future. [ABSTRACT 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 abstract 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 abstract. (Copyright applies to all Abstracts.)
ABSTRACT
Background: The SARS-CoV-2 pandemic is leading to hospitalizations and increased mortality worldwide. With potentially high prevalence and severity of COVID-19 in cardiac transplantation, there is a great need to generate data in this at-risk cohort. We report here our experience on outcome and treatment of heart transplant recipients infected with SARS-CoV-2 at a German transplant center longitudinally over the previous pandemic waves. Method(s): All adult patients who had received a heart transplant at our center and had confirmed COVID-19 infection between December 2020 and July 2022 (n = 48) were included and retrospectively characterized. Result(s): The median age was 60.5 (46.3-63.8) years, and the majority were male (83%). The hospitalization rate was 83%. Comorbidities included diabetes (31%), arterial hypertension (73%), and chronic renal failure (90%). The percentage of SARS-CoV-2 positive patients since the beginning of our vaccination campaign (03/2021) was 90%, while from those 43 patients, 88% were fully vaccinated at the time of infection (vaccine breakthrough). The median time from vaccination to infection within those patients was 138 (85-225) days. Antiviral therapy was given in 83% of all cases, and passive immunization (convalescent plasma/monoclonal antibodies) was performed in 98% of all cases. Oxygen administration was required in 10% of patients;only one patient required noninvasive ventilation (2%), and no patient required invasive ventilation or mechanical cardiovascular support (ECMO). No new cardiovascular or thromboembolic events were found, and we observed no COVID-19-associated mortality. Conclusion(s): Under increasing numbers of vaccinated patients and treatment options, we could not detect severe courses or increased mortality of COVID-19 in heart transplanted patients. Prospective studies are needed to make better prognostic estimates of COVID-19 in (heart) transplanted patients in the future.