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Impact of COVID-19 on Patients Supported with a Left Ventricular Assist Device

Jack Zakrzewski1, Laura Coyle2, Tracy Aicher2

  • 1From the Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|September 3, 2021
PubMed

Insights

Patients with left ventricular assist devices (LVAD) face severe coronavirus disease-19 (COVID-19) risks. This study found increased mortality and complications in LVAD patients with COVID-19, highlighting vulnerability in this population.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Patients requiring left ventricular assist device (LVAD) support often have advanced heart failure.
  • The impact of coronavirus disease-19 (COVID-19) on LVAD patients is not well-defined.
  • LVAD patients may be at higher risk for severe COVID-19 outcomes.

Purpose of the Study:

  • To describe the clinical course and outcomes of COVID-19 in patients with LVADs.
  • To identify factors associated with mortality in LVAD patients hospitalized with COVID-19.
  • To examine the postoperative course of LVAD implantation in patients with prior COVID-19 infection.

Main Methods:

  • Retrospective review of medical records at a single center.
  • Inclusion of 28 LVAD patients diagnosed with COVID-19 between March 2020 and March 2021.
  • Inclusion of six patients with prior COVID-19 infection who underwent LVAD implantation.

Main Results:

  • Nine out of 28 (32%) LVAD patients with COVID-19 died during the study period.
  • Five patients (18%) died during their initial COVID-19 hospitalization; two (7%) had suspected pump thrombosis.
  • Mechanical ventilation and intensive care unit admission were associated with increased mortality.
  • All six patients with prior COVID-19 experienced complicated postoperative courses, with three (50%) suffering ischemic strokes and one (17%) 30-day mortality.

Conclusions:

  • Left ventricular assist device patients are at increased risk of morbidity and mortality from COVID-19.
  • COVID-19 infection poses significant challenges for LVAD patients, both medically and post-surgically.
  • Further research is needed to understand and mitigate these risks.

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