Coronavirus Disease-2019 in Heart Transplant Recipients in Southeastern Michigan: A Case Series

J Card Fail. 2020 Jun;26(6):457-461. doi: 10.1016/j.cardfail.2020.05.008. Epub 2020 May 14.

Abstract

Background: Since coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China, in December 2019, the number of cases has risen exponentially. Clinical characteristics and outcomes among patients with orthotopic heart transplant (OHT) with COVID-19 remain poorly described.

Methods: We performed a retrospective case series of patients with OHT with COVID-19 admitted to 1 of 2 hospitals in Southeastern Michigan between March 21 and April 22, 2020. Clinical data were obtained through review of the electronic medical record. Final date of follow-up was May 7, 2020. Demographic, clinical, laboratory, radiologic, treatment, and mortality data were collected and analyzed.

Results: We identified 13 patients with OHT admitted with COVID-19. The mean age of patients was 61 ± 12 years, 100% were black males, and symptoms began 6 ± 4 days before admission. The most common symptoms included subjective fever (92%), shortness of breath (85%), and cough (77%). Six patients (46%) required admission to the intensive care unit. Two patients (15%) died during hospitalization.

Conclusions: Black men may be at increased risk for COVID-19 among patients with OHT. Presenting signs and symptoms in this cohort are similar to those in the general population. Elevated inflammatory markers on presentation appear to be associated with more severe illness.

Keywords: Advanced heart failure; COVID; heart transplant; immunosuppression.

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus*
  • COVID-19
  • Cohort Studies
  • Coronavirus Infections / complications*
  • Coronavirus Infections / mortality
  • Coronavirus Infections / therapy*
  • Critical Care
  • Female
  • Heart Failure / complications
  • Heart Failure / mortality
  • Heart Failure / surgery*
  • Heart Transplantation*
  • Hospitalization
  • Humans
  • Male
  • Michigan
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / therapy*
  • SARS-CoV-2