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Journal of Heart & Lung Transplantation ; 42(4):S262-S262, 2023.
Article in English | Academic Search Complete | ID: covidwho-2260085


Early use of anti-SARS-CoV-2 monoclonal antibodies has shown to be a safe option to reduce hospitalization and death in solid organ transplant recipients with COVID-19. Real world data regarding sotrovimab in heart transplant (HT) recipients is scarce. We aim to describe our experience in terms of safety and outcomes in this group. Consecutive HT recipients from our center with confirmed SARS-CoV-2 Omicron variant who received intravenous sotrovimab infusion between January and April 2022 were enrolled in this observational study. Clinical data was recorded including the first 24 hours post infusion, as well as 1-month and 3-month follow-ups. A total of 29 HT recipients with SARS-CoV-2 infection who received sotrovimab were enrolled [median age 53 (IQR 36, 62), 52% female]. Baseline characteristics are shown in Table 1. The median time since symptom onset was 2 (1,3) days, and 86% of patients had previously received ≥3 doses of COVID-19 vaccine. No acute infusion-related reactions were reported. A total of five patients were admitted (17%), 3 of them with COVID-19 pneumonitis, receiving high-dose steroids. Bacterial superinfection was reported in 4 patients. Neither invasive mechanical ventilation nor ICU care were required, and no in-hospital deaths were recorded. Hospitalized patients had more comorbidities [diabetes (40 vs 13%, p 0.13), hyperlipidemia (80 vs 29%, p 0.03), advanced chronic kidney disease (100 vs 38%, p 0.01), leucopenia (40 vs 4%, p 0.02), and anemia (100 vs 46%, 0.03)], compared to non-hospitalized patients. Over a median follow-up of 111 (86, 131) days, there were 2 cases of COVID-19 reinfection and 6 non-COVID-19-related readmissions. No episodes of acute rejection, new onset graft dysfunction or death were registered. In our series, the early use of sotrovimab in HT recipients with COVID-19 was safe. No COVID-19-related deaths were recorded, hospitalization rate was low and more frequent in patients with prior chronic comorbidities. [ 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.)

Heart ; 107(Suppl 2):A51, 2021.
Article in English | ProQuest Central | ID: covidwho-1463020


IntroductionSocial distancing measures were introduced in Ireland to address COVID-19 in March 2020. Strategies to continue Cardiology outpatient services needed to balance patient safety with the need for high quality follow-up care. Therefore, virtual consultations (via phone or video call) were implemented as temporary alternatives to in-person clinics.Objectives and MethodologyWe aimed to identify inefficiencies in physical outpatient services at Beaumont Hospital in comparison with virtual consultations. In face-to-face visits, a patient’s average time outside the physician’s examination room was 39 minutes (range 12-110 minutes). Increased delays occurred if investigations were awaited. The average face-to-face consultation lasted 24 minutes. Next, an analysis was performed on 100 consecutive patients’ virtual consultation experiences. Electronic survey responses were collected from stakeholders including patients, physicians, nurses, and clerical staff relating to these virtual visits.Results81% of outpatient consultations were delivered virtually from July to December 2021, with an average duration of 19 minutes. Patient volume was increased (5 additional patients per week per clinic) with a reduced waiting time for routine attendance. Criteria for outpatient re-attendance was regularly reviewed, with discharge facilitated at the second or third visit if clinically indicated. 89% of visits were supported by communications technology (smartphone or internet access) and 94% had access to a private location. 76% of patients reported that they were able to access their appointment without limitations in comparison to in-person consultations, although some reported a decreased personal connection with their physician. Satisfaction scores reflected this positive outlook (90/100 for patients and 75/100 for physicians), although patients reported that they would prefer virtual consultations less than 50% of the time outside the pandemic. Information was collected from patients on what aspects could be improved on the virtual service.Conclusion and ImplicationsVirtual clinics could be increasingly implemented in modern Cardiology. Telemedicine could provide a high-quality service with reduced cost and increased accessibility, particularly for patients in rural areas. In addition, virtual care at scale could allow in-person visits to be prioritised for patients who would truly benefit from their use, while reducing the risk of transmissible infections including COVID-19 and others.