COVID-19 among heart transplant recipients in Germany: a multicenter survey

Rivinius, Rasmus; Kaya, Ziya; Schramm, Rene; Boeken, Udo; Provaznik, Zdenek; Heim, Christian; Knosalla, Christoph; Schoenrath, Felix; Rieth, Andreas; Berchtold-Herz, Michael; Barten, Markus J.; Rauschning, Dominic; Muecke, Victoria T.; Heyl, Stephan; Pistulli, Rudin; Grinninger, Carola; Hagl, Christian; Gummert, Jan F.; Warnecke, Gregor; Schulze, P. Christian; Katus, Hugo A.; Kreusser, Michael M. und Raake, Philip W. (2020): COVID-19 among heart transplant recipients in Germany: a multicenter survey. In: Clinical Research in Cardiology, Bd. 109, Nr. 12: S. 1531-1539

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 andp < 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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1861-0684
• Sprache: Englisch