COVID-19 in heart transplant patients: Case reports from Brazil
Clin. transplant
; 35(8): 1-13, Aug. 2021. tab.
Article
in English
| Sec. Est. Saúde SP, CONASS, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1283696
Responsible library:
BR79.1
ABSTRACT
ABSTRACT The COVID-19 pandemic continues, with a late hyperinflammatory phase. The immunosuppressive therapy used in heart transplant patients, in theory, could reduce inflammation thus benefitting patients with COVID-19. So far, however, there is still very little literature on this subject. METHODS:
This is a single-center retrospective study. We described laboratory parameters and clinical outcomes from 11 heart transplant patients with COVID-19 assisted at Dante Pazzanese Institute of Cardiology between March and July 2020.RESULTS:
Patients with ages between 35 to 79 years, and heart transplantation occurred from 3 to 264 months. The main comorbidities were diabetes mellitus (9/11; 81.8%), hypertension (10/11; 90.9%), and chronic renal disease (6/11; 54.5%). Cyclosporine A was used in 10 (90.9%) patients, mycophenolate mofetil in 9 (81.8%), and mTOR inhibitor in 5 (45.5%). Fever and cough were observed in 8 (72.7%) patients, and dyspnea and gastrointestinal symptoms in 5 (45.5%). Lymphopenia was observed in 10 (90.9%) and thrombocytopenia in 5 (45.5%). The higher level of troponin associated with chest tomography above 50% infiltrates of ground-glass opacity (GGO) was observed in those with the worst outcomes. Nine patients needed intensive care, and hospital stay ranged from 4 to 21 days, with 2 (18.2%) patients requiring vasopressor drugs and mechanical ventilation, and three patients (27.3%) dying due to COVID-19 complications.CONCLUSION:
Heart transplant patients had the similar symptoms and outcomes as general population; immunosuppressive therapy seems not to have protected them. Patients who presented higher levels of troponin and D-dimer, associated to greater GGO pulmonary infiltrates had worse outcomes. More studies with larger cohorts may clarify immunosuppressive effects on COVID-19 outcomes.
Full text:
Available
Collection:
National databases
/
Brazil
Health context:
SDG3 - Target 3.3 End transmission of communicable diseases
/
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
COVID-19
/
Pneumonia
/
Other Respiratory Diseases
Database:
CONASS
/
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Heart Transplantation
/
Severe Acute Respiratory Syndrome
/
Transplant Recipients
Type of study:
Observational study
/
Risk factors
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Clin. transplant
Year:
2021
Document type:
Article
Institution/Affiliation country:
Department of Heart Transplantation, Dante Pazzanese Institute of Cardiology/BR
/
Laboratory of Molecular Investigation in Cardiology, Dante Pazzanese Institute of Cardiology/BR