Coronavirus Disease 2019 and Heart Transplantation: Single-Center Experience and Review of the Literature

Authors

Daniel Greenberg, From the Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.
Bo Li, From the Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.
Kenji Okumura, Department of Surgery, New York Medical College/Westchester Medical Center, Valhalla, NY.
Christopher Nabors, From the Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.Follow
Abhay Dhand, From the Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.Follow

Author Type(s)

Faculty

DOI

10.1097/CRD.0000000000000464

Journal Title

Cardiology in Review

First Page

168

Last Page

172

Document Type

Article

Publication Date

5-1-2023

Department

Medicine

Abstract

Coronavirus disease 2019 (COVID-19) was declared a global pandemic in March 2020, and since then it has had a significant impact on healthcare including on solid organ transplantation. Based on age, immunosuppression, and prevalence of chronic comorbidities, heart transplant recipients are at high risk of adverse outcomes associated with COVID-19. In our center, 31 heart transplant recipients were diagnosed with COVID-19 from March 2020 to September 2021. They required: hospitalization (39%), intensive care (10%), and mechanical ventilation (6%) with overall short-term mortality of 3%. Early outpatient use of anti-SARS CoV-2 monoclonal antibodies in our heart transplant recipients was associated with a reduction in the risk of hospitalization, need for intensive care, and death related to COVID-19. In prior multicenter studies, completed in different geographic areas and pandemic timeframes, diverse rates of hospitalization (38-91%), mechanical ventilation (4-38%), and death (16-33%) have been reported. Progression of disease and adverse outcomes were most significantly associated with severity of lymphopenia, chronic comorbid conditions like older age, chronic allograft vasculopathy, increased body mass index, as well as intensity of baseline immune suppression. In this article, we also review the current roles and limitations of vaccination, anti-viral agents, and anti-severe acute respiratory syndrome coronavirus 2 monoclonal antibodies in the management of heart transplant recipients. Our single-center experience, considered together with other studies indicates a trend toward improved outcomes among heart transplant patients with COVID-19.

Recommended Citation

Greenberg, D., Li, B., Okumura, K., Nabors, C., & Dhand, A. (2023). Coronavirus Disease 2019 and Heart Transplantation: Single-Center Experience and Review of the Literature. Cardiology in Review, 31 (3), 168-172. https://doi.org/10.1097/CRD.0000000000000464