COVID-19 and Heart Transplantation. Initial Experience in a Tertiary Hospital.
Transplant Proc
; 53(9): 2743-2746, 2021 Nov.
Article
in English
| MEDLINE | ID: covidwho-1447201
ABSTRACT
BACKGROUND:
Coronavirus disease 2019 (COVID-19) is a viral infectious disease caused by the severe acute respiratory syndrome coronavirus 2 virus that is affecting the entire world population. The objective of this study was to analyze the repercussion of the disease in a group of patients at risk such as heart transplant recipients.METHODS:
From February 2020 to February 2021, heart transplant recipients diagnosed with COVID-19 were consecutively included. The total number of transplant recipients in outpatient follow-up at that time was 381. Three levels of infection were determined group A asymptomatic patients or with trivial symptoms without the need for hospital admission (6 patients); group B patients admitted to the hospital for respiratory symptoms (12 patients); and group C patients with severe symptoms and need for admission to the critical care unit (2 patients). At each risk level, medical performance was different group A close control, no therapeutic modification; group B reduction of calcineurin inhibitor and substitution of mycophenolate mofetil for everolimus; group C reduction of calcineurin inhibitor and withdrawal of mycophenolate mofetil.RESULTS:
The prevalence of infection in the series was 5.2%. Most patients admitted had a pathologic chest x-ray with fever, cough, dyspnea, or vomiting. The change in immunosuppression performed in patients in group 2 was well tolerated and there was no graft rejection. Antiviral treatment was little used. However, boluses of steroids and some antibiotics were used frequently. The need for supplemental oxygen was 50% in group 2 and 100% in group 3.CONCLUSIONS:
A significant number of transplant recipients will be affected by COVID-19 (5.3%). Management of the infection will depend on the severity of the infection and must be based on a balance between reduction and adjustment of immunosuppression, strict control of the cardiologic situation, and treatment of the infection.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Heart Transplantation
/
Kidney Transplantation
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Transplant Proc
Year:
2021
Document Type:
Article
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