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Outcomes Associated With COVID-19 Hospitalization in Heart Transplantation Patients

Christopher N Kanaan1, Jean-Pierre Iskandar1, Mohamed M Gad1

  • 1Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio.

Transplantation Proceedings
|August 23, 2022
PubMed

Insights

Heart transplant recipients with COVID-19 did not experience worse outcomes compared to controls. This finding held true regardless of the time since transplantation, suggesting immunosuppression did not significantly impact COVID-19 severity in this cohort.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Immunology

Background:

  • Heart transplantation (HT) recipients are often chronically immunosuppressed, potentially increasing their risk of severe COVID-19.
  • Understanding COVID-19 outcomes in HT patients is crucial for managing post-transplant care.

Purpose of the Study:

  • To compare COVID-19 outcomes in heart transplant recipients versus non-transplant controls.
  • To analyze the impact of time since transplantation on COVID-19 severity in HT patients.

Main Methods:

  • Retrospective cohort study of adult HT patients hospitalized with COVID-19 (March 2020-March 2021).
  • Matched 24 HT cases with 96 non-HT controls based on baseline characteristics.
  • Assessed all-cause mortality, mechanical ventilation, ICU admission, vasopressor need, dialysis, pneumonia, and 90-day readmission.

Main Results:

  • No significant differences were observed in primary (all-cause mortality) or secondary outcomes between HT recipients and controls.
  • Subgroup analysis showed no significant difference in mortality or 30-day readmission based on time from transplantation (within 1 year vs. >1 year).
  • Immunosuppressant management (continuation, dose reduction, or discontinuation) did not significantly affect HT patient mortality.

Conclusions:

  • Heart transplant recipients with COVID-19 may not have worse outcomes than non-transplant patients, even within the first year post-transplant.
  • Further research with larger, multicenter datasets is needed to investigate variants, long COVID, and varying immunosuppression strategies.
Abstract

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