Long COVID sequelae in heart transplant recipients

Post acute sequelae of SARS-CoV-2 infection (also known as Long COVID) have been defined as symptoms that persist after 3 months from initial acute episode of COVID-19. While the pathophysiology and mechanisms that cause Long COVID are hypothesized as secondary to persistent inflammation and immune dysregulation, the burden of this disease remains difficult to estimate due to varied symptomatology. Solid-organ transplant recipients in particular remain a vulnerable population that has been disproportionately affected by the COVID-19 pandemic, and the impact of Long COVID among orthotopic heart transplant recipients (OHTRs)-a patient population on chronic immunosuppressive therapy-remains incompletely characterized. We sought to evaluate patient-reported Long COVID symptoms between OHTRs compared to patients with baseline cardiomyopathy. We conducted a prospective survey-based study of adult OHTRs and cardiomyopathy control patients with documented SARS-CoV-2 infection. Participants completed telephone surveys, which included questionnaires of symptoms, quality of life (QOL), and mental health assessment. Between-group differences were evaluated using multivariable models adjusting for baseline characteristics. Our results show that the prevalence of Long COVID symptoms did not significantly differ between OHTRs and patients with cardiomyopathy. Dyspnea was reported more frequently in the non-OHTR group; however, this association was attenuated after adjusting for a higher burden of underlying pulmonary disease. No evidence of increased overall symptom burden was observed among OHTRs. In this first comparative analysis of Long COVID among OHTRs and control cardiomyopathy patients, OHTRs demonstrated no increase in symptom burden and may experience fewer persistent symptoms.