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. 2022 Mar 1;106(3):641-647.
doi: 10.1097/TP.0000000000003770.

Characteristics and Outcomes of Heart Transplant Recipients With Coronavirus-19 Disease in a High-volume Transplant Center

Fabiana G Marcondes-Braga  1 , Ciro M Murad, Deborah S P Belfort, Rafael C T Dantas, Maria Tereza S S Lira, Carlos A S Aragão, Rinaldo F Siciliano, Sandrigo Mangini, Luis Fernando B C Seguro, Iáscara W Campos, Mônica S Avila, Mariana V O Bello, Fernanda B A Dos Santos, Tânia M V Strabelli, Fabio A Gaiotto, Fernando Bacal
Affiliations

Characteristics and Outcomes of Heart Transplant Recipients With Coronavirus-19 Disease in a High-volume Transplant Center

Fabiana G Marcondes-Braga et al. Transplantation. .

Abstract

Background: Heart transplant (HT) recipients may be at higher risk of acquiring SARS-CoV-2 infection and developing critical illness. The aim of this study is to describe characteristics and outcomes of HT recipients infected by SARS-COV-2, from a high-volume transplant center.

Methods: We have described data of all adult HT recipients with confirmed coronavirus disease 2019 by RT-PCR in nasopharyngeal samples from April 5, 2020, to January 5, 2021. Outcomes and follow-up were recorded until February 5, 2021.

Results: Forty patients were included. Twenty-four patients (60%) were men; the median age was 53 (40-60) y old; median HT time was 34 mo; and median follow-up time 162 d. The majority needed hospitalization (83%). Immunosuppressive therapy was reduced/withdrawn in the majority of patients, except from steroids, which were maintained. Seventeen patients (42.5%) were classified as having severe disease according to the ordinal scale developed by the World Health Organization Committee. They tended to have lower absolute lymphocyte count (P < 0.001) during follow-up when compared with patients with mild disease. Thirty-day mortality was 12.5%. However, a longer follow-up revealed increased later mortality (27.5%), with median time to death around 35 d. Bacterial nosocomial infections were a leading cause of death. Cardiac allograft rejection (10%) and ventricular dysfunction (12.5%) were also not negligible.

Conclusions: Major findings of this study corroborate other cohorts' results, but it also reports significant rate of later events, suggesting that a strict midterm surveillance is advisable to HT recipients with coronavirus disease 2019.

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Conflict of interest statement

The authors declare no funding or conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Absolute lymphocyte count and outcomes in heart transplant recipients with COVID-19. Absolute lymphocyte count nadir in heart transplanted recipients who developed mild and severe disease (A) and who died or not (B). COVID-19, coronavirus disease 2019.
See this image and copyright information in PMC

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