TY  - BOOK
AU  - Molina, Ezequiel
AU  - Najjar, Samer S
AU  - Rodrigo, Maria
TI  - Coronavirus disease 2019 in heart transplant recipients: Risk factors, immunosuppression, and outcomes
SN  - 1053-2498
PY  - 2021///
KW  - *COVID-19/ep [Epidemiology]
KW  - *Heart Failure/su [Surgery]
KW  - *Heart Transplantation
KW  - *Immunosuppressive Agents/tu [Therapeutic Use]
KW  - Aged
KW  - COVID-19/di [Diagnosis]
KW  - COVID-19/th [Therapy]
KW  - Female
KW  - Heart Failure/co [Complications]
KW  - Heart Failure/mo [Mortality]
KW  - Hospitalization
KW  - Humans
KW  - Logistic Models
KW  - Male
KW  - Middle Aged
KW  - Risk Factors
KW  - Survival Rate
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1999 - present, Available in print through MWHC library:1999-2007
N2  - BACKGROUND: COVID-19 continues to inflict significant morbidity and mortality, particularly on patients with preexisting health conditions. The clinical course, outcomes, and significance of immunosuppression regimen in heart transplant recipients with COVID-19 remains unclear; CONCLUSIONS: We present the largest study to date of heart transplant patients with COVID-19 showing common atypical presentations and a high case fatality rate of 24% among hospitalized patients and 16% among symptomatic patients. Copyright (c) 2021 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved; METHODS: We included the first 99 heart transplant recipients at participating centers with COVID-19 and followed patients until resolution. We collected baseline information, symptoms, laboratory studies, vital signs, and outcomes for included patients. The association of immunosuppression regimens at baseline with severe disease were compared using logistic regression, adjusting for age and time since transplant; RESULTS: The median age was 60 years, 25% were female, and 44% were white. The median time post-transplant to infection was 5.6 years. Overall, 15% died, 64% required hospital admission, and 7% remained asymptomatic. During the course of illness, only 57% of patients had a fever, and gastrointestinal symptoms were common. Tachypnea, oxygen requirement, elevated creatinine and inflammatory markers were predictive of severe course. Age >= 60 was associated with higher risk of death and the use of the combination of calcineurin inhibitor, antimetabolite, and prednisone was associated with more severe disease compared to the combination of calcineurin inhibitor and antimetabolite alone (adjusted OR = 7.3, 95% CI 1.8-36.2). Among hospitalized patients, 30% were treated for secondary infection, acute kidney injury was common and 17% required new renal replacement therapy
UR  - https://dx.doi.org/10.1016/j.healun.2021.05.006
ER  -