tetano
Editor, Senior Moderator
Clin Res Cardiol
. 2020 Aug 11.
doi: 10.1007/s00392-020-01722-w. Online ahead of print.
COVID-19 among heart transplant recipients in Germany: a multicenter survey
Rasmus Rivinius[SUP] 1 2 [/SUP], Ziya Kaya[SUP] 1 2 [/SUP], Ren? Schramm[SUP] 3 [/SUP], Udo Boeken[SUP] 4 [/SUP], Zdenek Provaznik[SUP] 5 [/SUP], Christian Heim[SUP] 6 [/SUP], Christoph Knosalla[SUP] 7 8 [/SUP], Felix Schoenrath[SUP] 7 8 [/SUP], Andreas Rieth[SUP] 9 [/SUP], Michael Berchtold-Herz[SUP] 10 [/SUP], Markus J Barten[SUP] 11 [/SUP], Dominic Rauschning[SUP] 12 [/SUP], Victoria T M?cke[SUP] 13 [/SUP], Stephan Heyl[SUP] 14 [/SUP], Rudin Pistulli[SUP] 15 [/SUP], Carola Grinninger[SUP] 16 17 [/SUP], Christian Hagl[SUP] 16 17 [/SUP], Jan F Gummert[SUP] 3 [/SUP], Gregor Warnecke[SUP] 2 18 [/SUP], P Christian Schulze[SUP] 19 [/SUP], Hugo A Katus[SUP] 1 2 [/SUP], Michael M Kreusser[SUP] 20 21 22 [/SUP], Philip W Raake[SUP] 1 2 [/SUP]
Affiliations
Abstract
Aims: Heart transplantation may represent a particular risk factor for severe coronavirus infectious disease 2019 (COVID-19) due to chronic immunosuppression and frequent comorbidities. We conducted a nation-wide survey of all heart transplant centers in Germany presenting the clinical characteristics of heart transplant recipients with COVID-19 during the first months of the pandemic in Germany.
Methods and results: A multicenter survey of all heart transplant centers in Germany evaluating the current status of COVID-19 among adult heart transplant recipients was performed. A total of 21 heart transplant patients with COVID-19 was reported to the transplant centers during the first months of the pandemic in Germany. Mean patient age was 58.6 ? 12.3 years and 81.0% were male. Comorbidities included arterial hypertension (71.4%), dyslipidemia (71.4%), diabetes mellitus (33.3%), chronic kidney failure requiring dialysis (28.6%) and chronic-obstructive lung disease/asthma (19.0%). Most patients received an immunosuppressive drug regimen consisting of a calcineurin inhibitor (71.4%), mycophenolate mofetil (85.7%) and steroids (71.4%). Eight of 21 patients (38.1%) displayed a severe course needing invasive mechanical ventilation. Those patients showed a high mortality (87.5%) which was associated with right ventricular dysfunction (62.5% vs. 7.7%; p = 0.014), arrhythmias (50.0% vs. none; p = 0.012), and thromboembolic events (50.0% vs. none; p = 0.012). Elevated high-sensitivity cardiac troponin T- and N-terminal prohormone of brain natriuretic peptide were significantly associated with the severe form of COVID-19 (p = 0.017 and p < 0.001, respectively).
Conclusion: Severe course of COVID-19 was frequent in heart transplanted patients. High mortality was associated with right ventricular dysfunction, arrhythmias, thromboembolic events, and markedly elevated cardiac biomarkers.
Keywords: COVID-19; Heart transplantation; Immunosuppression; Mortality.
. 2020 Aug 11.
doi: 10.1007/s00392-020-01722-w. Online ahead of print.
COVID-19 among heart transplant recipients in Germany: a multicenter survey
Rasmus Rivinius[SUP] 1 2 [/SUP], Ziya Kaya[SUP] 1 2 [/SUP], Ren? Schramm[SUP] 3 [/SUP], Udo Boeken[SUP] 4 [/SUP], Zdenek Provaznik[SUP] 5 [/SUP], Christian Heim[SUP] 6 [/SUP], Christoph Knosalla[SUP] 7 8 [/SUP], Felix Schoenrath[SUP] 7 8 [/SUP], Andreas Rieth[SUP] 9 [/SUP], Michael Berchtold-Herz[SUP] 10 [/SUP], Markus J Barten[SUP] 11 [/SUP], Dominic Rauschning[SUP] 12 [/SUP], Victoria T M?cke[SUP] 13 [/SUP], Stephan Heyl[SUP] 14 [/SUP], Rudin Pistulli[SUP] 15 [/SUP], Carola Grinninger[SUP] 16 17 [/SUP], Christian Hagl[SUP] 16 17 [/SUP], Jan F Gummert[SUP] 3 [/SUP], Gregor Warnecke[SUP] 2 18 [/SUP], P Christian Schulze[SUP] 19 [/SUP], Hugo A Katus[SUP] 1 2 [/SUP], Michael M Kreusser[SUP] 20 21 22 [/SUP], Philip W Raake[SUP] 1 2 [/SUP]
Affiliations
- PMID: 32783099
- DOI: 10.1007/s00392-020-01722-w
Abstract
Aims: Heart transplantation may represent a particular risk factor for severe coronavirus infectious disease 2019 (COVID-19) due to chronic immunosuppression and frequent comorbidities. We conducted a nation-wide survey of all heart transplant centers in Germany presenting the clinical characteristics of heart transplant recipients with COVID-19 during the first months of the pandemic in Germany.
Methods and results: A multicenter survey of all heart transplant centers in Germany evaluating the current status of COVID-19 among adult heart transplant recipients was performed. A total of 21 heart transplant patients with COVID-19 was reported to the transplant centers during the first months of the pandemic in Germany. Mean patient age was 58.6 ? 12.3 years and 81.0% were male. Comorbidities included arterial hypertension (71.4%), dyslipidemia (71.4%), diabetes mellitus (33.3%), chronic kidney failure requiring dialysis (28.6%) and chronic-obstructive lung disease/asthma (19.0%). Most patients received an immunosuppressive drug regimen consisting of a calcineurin inhibitor (71.4%), mycophenolate mofetil (85.7%) and steroids (71.4%). Eight of 21 patients (38.1%) displayed a severe course needing invasive mechanical ventilation. Those patients showed a high mortality (87.5%) which was associated with right ventricular dysfunction (62.5% vs. 7.7%; p = 0.014), arrhythmias (50.0% vs. none; p = 0.012), and thromboembolic events (50.0% vs. none; p = 0.012). Elevated high-sensitivity cardiac troponin T- and N-terminal prohormone of brain natriuretic peptide were significantly associated with the severe form of COVID-19 (p = 0.017 and p < 0.001, respectively).
Conclusion: Severe course of COVID-19 was frequent in heart transplanted patients. High mortality was associated with right ventricular dysfunction, arrhythmias, thromboembolic events, and markedly elevated cardiac biomarkers.
Keywords: COVID-19; Heart transplantation; Immunosuppression; Mortality.