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Heart Lung ; 49(6): 808-811, 2020.
Article in English | MEDLINE | ID: covidwho-778905


IMPORTANCE: As the Coronavirus disease 2019 (COVID-19) pandemic accelerates, our hospitals have become overwhelmed. OBJECTIVE: To describe detection of COVID-19 in asymptomatic hospitalized individuals awaiting advanced therapies for HF and the management of complications of COVID-19. DESIGN: We present a unique case report of hospital-acquired COVID-19 in a patient on temporary mechanical circulatory support. MAIN OUTCOME: Despite intensive care and monitoring, he developed rapid progression of hypoxic respiratory failure which led to his death. CONCLUSION: This case highlights various considerations for a patient with temporary MCS. It illustrates the high risk for development of COVID-19 for vulnerable hospitalized patients.

Coronavirus Infections , Cross Infection , Heart Failure , Heart-Assist Devices , Pandemics , Pneumonia, Viral , Asymptomatic Infections , Betacoronavirus , COVID-19 , Clinical Deterioration , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Cross Infection/complications , Cross Infection/diagnosis , Fatal Outcome , Heart Failure/complications , Heart Failure/therapy , Hospitalization , Humans , Male , Middle Aged , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , SARS-CoV-2
J Heart Lung Transplant ; 39(9): 894-903, 2020 09.
Article in English | MEDLINE | ID: covidwho-613985


BACKGROUND: Orthotopic heart transplantation (OHT) recipients may be particularly vulnerable to coronavirus disease 2019 (COVID-19). OHT during the pandemic presents unique challenges in terms of feasibility and safety. METHODS: Chart review was performed for consecutive OHT recipients with COVID-19 and waitlisted patients who underwent OHT from March 1, 2020 to May 15, 2020. RESULTS: Of the approximately 400 OHT recipients followed at our institution, 22 acquired COVID-19. Clinical characteristics included median age 59 (range, 49-71) years, 14 (63.6%) were male, and median time from OHT to infection was 4.6 (2.5-20.6) years. Symptoms included fever (68.2%), gastrointestinal complaints (55%), and cough (46%). COVID-19 was severe or critical in 5 (23%). All patients had elevated inflammatory biomarkers. Immunosuppression was modified in 85% of patients. Most (n = 16, 86.4%) were hospitalized, 18% required intubation, and 14% required vasopressor support. Five patients (23%) expired. None of the patients requiring intubation survived. Five patients underwent OHT during the pandemic. They were all males, ranging from 30 to 59 years of age. Two were transplanted at United Network of Organ Sharing Status 1 or 2, 1 at Status 3, and 2 at Status 4. All were successfully discharged and are alive without allograft dysfunction or rejection. One contracted mild COVID-19 after the index hospitalization. CONCLUSION: OHT recipients with COVID-19 appear to have outcomes similar to the general population hospitalized with COVID-19. OHT during the pandemic is feasible when appropriate precautions are taken. Further study is needed to guide immunosuppression management in OHT recipients affected by COVID-19.

Betacoronavirus , Coronavirus Infections/complications , Graft Rejection/prevention & control , Heart Failure/surgery , Heart Transplantation/methods , Immunosuppression Therapy/methods , Immunosuppressive Agents/therapeutic use , Pneumonia, Viral/complications , Aged , COVID-19 , Coronavirus Infections/epidemiology , Feasibility Studies , Female , Heart Failure/complications , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Retrospective Studies , Risk Factors , SARS-CoV-2 , Transplantation, Homologous , Treatment Outcome