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Long Covid as an Indication for Heart Transplantation and Its Characteristics

Joao Manoel Rossi Neto1, Raphael Machado Rossi1, Plinio Jose Whitaker Wolf1

  • 1Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil.

Transplantation Proceedings
|May 7, 2023
PubMed

Insights

Long COVID (LC) patients requiring heart transplantation present with unique characteristics, including low ejection fraction and fewer comorbidities. These findings highlight a distinct clinical profile of advanced heart failure post-COVID-19.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Transplantation

Background:

  • Post-acute cardiovascular complications of COVID-19 (long COVID) remain poorly understood.
  • Increased risk of heart failure observed in individuals post-SARS-CoV-2 infection, even without prior cardiovascular disease.
  • Limited data exists on long COVID patients with advanced heart failure unresponsive to standard medical treatments.

Purpose of the Study:

  • To characterize patients with long COVID (LC) who were listed for heart transplantation.
  • To compare the clinical features of LC patients with those of other etiologies requiring heart transplantation.

Main Methods:

  • Retrospective analysis of 45 patients listed for heart transplantation between January 2020 and March 2022.
  • Categorization into two groups: patients with LC (n=4) and patients with other etiologies (n=41).
  • Description of patient characteristics as the primary study endpoint.

Main Results:

  • Long COVID patients were oligosymptomatic during acute infection and did not require hospitalization.
  • LC patients exhibited lower ejection fraction, higher utilization of intra-aortic balloon pumps, and lower pulmonary vascular resistance.
  • Compared to other etiologies, LC patients had fewer comorbidities, suggesting a low cardiac output presentation rather than congestion.

Conclusions:

  • This study provides early insights into the characteristics of heart transplant candidates with long COVID-related heart failure.
  • The distinct clinical profile of these patients warrants further extensive research.
  • These preliminary findings underscore the complex cardiovascular sequelae of COVID-19.
Abstract

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