tetano
Editor, Senior Moderator
Transpl Int
. 2021 Feb 4.
doi: 10.1111/tri.13837. Online ahead of print.
Clinical Manifestations and Outcomes of Coronavirus Disease-19 in Heart Transplant Recipients: A Multicenter Case Series with a Systematic Review and Meta-Analysis
Camille Granger[SUP] 1 [/SUP], Paul Guedeney[SUP] 1 [/SUP], Camille Arnaud[SUP] 2 [/SUP], Soulef Guendouz[SUP] 3 [/SUP], Claire Cimadevilla[SUP] 2 [/SUP], Mathieu Kerneis[SUP] 1 [/SUP], Caroline Kerneis[SUP] 2 [/SUP], Michel Zeitouni[SUP] 1 [/SUP], Constance Verdonk[SUP] 2 [/SUP], Camille Legeai[SUP] 4 [/SUP], Guillaume Lebreton[SUP] 5 [/SUP], Pascal Leprince[SUP] 5 [/SUP], Eva D?sir?[SUP] 5 [/SUP], Sabato Sorrentino[SUP] 6 [/SUP], Johanne Silvain[SUP] 1 [/SUP], Gilles Montalescot[SUP] 1 [/SUP], Fanny Hazan[SUP] 5 [/SUP], Shaida Varnous[SUP] 5 [/SUP], Richard Dorent[SUP] 2 4 [/SUP]
Affiliations
Abstract
Background: Available data on clinical presentation and mortality of coronavirus disease-2019 (COVID-19) in heart transplant (HT) recipients remain limited.
Methods: We report a case series of laboratory-confirmed COVID-19 in 39 HT recipients from 3 French heart transplant centers (mean age 54.4?14.8 years; 66.7% males).
Results: Hospital admission was required for 35 (89.7%) cases including 14/39 (35.9%) cases being admitted in intensive care unit. Immunosuppressive medications were reduced or discontinued in 74.4% of the patients. After a median follow-up of 54 (19 - 80) days, death and death or need for mechanical ventilation occurred in 25.6% and 33.3% of patients, respectively. Elevated C-reactive protein and lung involvement ≥50% on chest computed tomography (CT) at admission were associated with an increased risk of death or need for mechanical ventilation. Mortality rate from March to June in the entire 3-center HT recipient cohort was 56% higher in 2020 compared to the time-matched 2019 cohort (2% versus 1.28%, p=0.15). In a meta-analysis including 4 studies, preexisting diabetes mellitus (OR 3.60, 95% CI 1.43 - 9.06, I[SUP]2[/SUP] =0%, p=0.006) and chronic kidney disease stage III or higher (OR 3.79, 95% CI 1.39 - 10.31, I[SUP]2[/SUP] = 0%, p=0.009) were associated with increased mortality.
Conclusion: These findings highlight the aggressive clinical course of COVID-19 in HT recipients.
Keywords: COVID-19; Heart transplant; immunosuppressive medication.
. 2021 Feb 4.
doi: 10.1111/tri.13837. Online ahead of print.
Clinical Manifestations and Outcomes of Coronavirus Disease-19 in Heart Transplant Recipients: A Multicenter Case Series with a Systematic Review and Meta-Analysis
Camille Granger[SUP] 1 [/SUP], Paul Guedeney[SUP] 1 [/SUP], Camille Arnaud[SUP] 2 [/SUP], Soulef Guendouz[SUP] 3 [/SUP], Claire Cimadevilla[SUP] 2 [/SUP], Mathieu Kerneis[SUP] 1 [/SUP], Caroline Kerneis[SUP] 2 [/SUP], Michel Zeitouni[SUP] 1 [/SUP], Constance Verdonk[SUP] 2 [/SUP], Camille Legeai[SUP] 4 [/SUP], Guillaume Lebreton[SUP] 5 [/SUP], Pascal Leprince[SUP] 5 [/SUP], Eva D?sir?[SUP] 5 [/SUP], Sabato Sorrentino[SUP] 6 [/SUP], Johanne Silvain[SUP] 1 [/SUP], Gilles Montalescot[SUP] 1 [/SUP], Fanny Hazan[SUP] 5 [/SUP], Shaida Varnous[SUP] 5 [/SUP], Richard Dorent[SUP] 2 4 [/SUP]
Affiliations
- PMID: 33539616
- DOI: 10.1111/tri.13837
Abstract
Background: Available data on clinical presentation and mortality of coronavirus disease-2019 (COVID-19) in heart transplant (HT) recipients remain limited.
Methods: We report a case series of laboratory-confirmed COVID-19 in 39 HT recipients from 3 French heart transplant centers (mean age 54.4?14.8 years; 66.7% males).
Results: Hospital admission was required for 35 (89.7%) cases including 14/39 (35.9%) cases being admitted in intensive care unit. Immunosuppressive medications were reduced or discontinued in 74.4% of the patients. After a median follow-up of 54 (19 - 80) days, death and death or need for mechanical ventilation occurred in 25.6% and 33.3% of patients, respectively. Elevated C-reactive protein and lung involvement ≥50% on chest computed tomography (CT) at admission were associated with an increased risk of death or need for mechanical ventilation. Mortality rate from March to June in the entire 3-center HT recipient cohort was 56% higher in 2020 compared to the time-matched 2019 cohort (2% versus 1.28%, p=0.15). In a meta-analysis including 4 studies, preexisting diabetes mellitus (OR 3.60, 95% CI 1.43 - 9.06, I[SUP]2[/SUP] =0%, p=0.006) and chronic kidney disease stage III or higher (OR 3.79, 95% CI 1.39 - 10.31, I[SUP]2[/SUP] = 0%, p=0.009) were associated with increased mortality.
Conclusion: These findings highlight the aggressive clinical course of COVID-19 in HT recipients.
Keywords: COVID-19; Heart transplant; immunosuppressive medication.