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Published on: April 27, 2019
COVID-19 Infection in Heart Transplants in Pre- and Postvaccination Periods
Víctor Donoso Trenado1, Raquel López-Vilella1, Ignacio Sánchez-Lázaro2
1Heart Failure and Transplantation Unit, La Fe University and Polytechnic Hospital, Valencia, Spain; Department of Cardiology, La Fe University and Polytechnic Hospital, Valencia, Spain.
Insights
Heart transplant recipients are vulnerable to COVID-19. Vaccination reduced nonsevere pneumonia hospitalizations and mortality in this group, though severe cases remain high risk.
Area of Science:
- Immunology
- Infectious Diseases
- Transplant Medicine
Background:
- Heart transplant (HTx) recipients are a vulnerable population for COVID-19 infection.
- Vaccination has significantly impacted the COVID-19 pandemic's trajectory.
- This study analyzes COVID-19 outcomes in HTx recipients before and after vaccination.
Purpose of the Study:
- To compare COVID-19 severity and outcomes in heart transplant recipients before and after the introduction of vaccination.
- To assess the impact of vaccination on hospitalization rates and mortality in this immunocompromised group.
Main Methods:
- Retrospective analysis of 65 heart transplant recipients diagnosed with COVID-19 between February 2020 and April 2022.
- Patients were divided into pre-vaccination (Feb 2020-Feb 2021) and post-vaccination (Mar 2021-Apr 2022) periods.
- COVID-19 severity was categorized into three groups: mild, nonsevere pneumonia, and severe pneumonia.
Main Results:
- In the pre-vaccination period, 22 recipients had COVID-19, with 14% experiencing severe pneumonia and a 2/22 mortality rate.
- In the post-vaccination period, 43 recipients had COVID-19, with 9% experiencing severe pneumonia and a 3/4 mortality rate.
- Hospital stay was slightly reduced post-vaccination (15 vs. 16 days).
Conclusions:
- Despite vaccination, severe COVID-19 in heart transplant recipients remains associated with high mortality.
- Vaccination demonstrated a trend towards reducing hospitalizations for nonsevere pneumonia in this cohort.
- Continued vigilance and management strategies are crucial for managing COVID-19 in heart transplant recipients.
Background:
Heart transplant (HTx) recipients constitute a group vulnerable to COVID-19 infection. Vaccination has been a turning point in the evolution of the pandemic. The objective was to analyze a series of HTx recipients with COVID-19 prior to vaccination and post vaccination.
Methods:
Inclusion: All HTx recipients diagnosed with COVID-19 (February 2020 to April 2022).
Exclusion:
HTx younger than 16 years. They were subdivided into prevaccination period (February 2020 to February 2021) and postvaccination period (March 2021 to April 2022). They were classified into 3 groups according to severity. Group 1: mild symptoms without admission. Group 2: admission for nonsevere pneumonia. Group 3: severe pneumonia according to American Thoracic Society/Infectious Diseases Society of America criteria. The general therapeutic attitude before and after vaccination was similar in both groups.
Results:
A total of 65 HTx recipients have had COVID-19 to date (10.7% of the 374 HTx recipients alive). In the prevaccination period, 22 HTx recipients presented the disease (Fig 1A): 27% in group 1; 59% were admitted for nonsevere pneumonia (group 2), with favorable evolution and a mean stay of 16 days; and 14% in group 3 (criteria for severe pneumonia), with 2 HTx recipients dying in this group. In the postvaccination period, 43 HTx recipients have presented COVID-19 (Fig 1B), 49% in group 1, 42% in group 2, and 9% in group 3. The hospital stay is slightly reduced to 15 days and 3 of the 4 patients in group 3 have died (mortality rate 7%).
Conclusions:
A significant number of HTx recipients have been affected by COVID-19, associating high mortality in severe forms both in the pre- and postvaccination period. In our series of patients, vaccination has reduced the percentage of hospitalization for nonsevere pneumonia slightly below the average hospitalization and mortality.
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