COVID-19 fatality rate high for heart transplant recipients

(HealthDay)—Heart transplant (HT) recipients with COVID-19 infection have a case fatality rate of 25 percent, according to a study published online May 13 in JAMA Cardiology.

Farhana Latif, M.D., from the Columbia University Vagelos College of Physicians and Surgeons in New York City, and colleagues describe the characteristics, treatment, and outcomes of HT recipients with COVID-19. Data were included for 28 patients with HT (median age, 64.0 years; 79 percent men; median of 8.6 years from HT) who received a confirmed diagnosis of COVID-19.

The researchers found that comorbid conditions included hypertension, diabetes, and cardiac allograft vasculopathy in 20, 17, and 16 patients, respectively. Twenty-two of the patients (79 percent) were admitted for treatment, and mechanical ventilation was required for seven patients (25 percent). Most of the patients had evidence of myocardial injury and elevated inflammatory biomarkers. Mycophenolate mofetil was discontinued in 16 of the patients managed at the study institution (70 percent), and six had a reduction in the dose of their calcineurin inhibitor. Hydroxychloroquine, high-dose corticosteroids, and interleukin 6 receptor antagonists were used for treatment of COVID-19. Seven patients died (25 percent). Of the 22 patients who were admitted, 11 were discharged home, while four and seven remained hospitalized at the end of the study and died during hospitalization, respectively.

"The high case fatality rate in this cohort calls for close monitoring of recipients of HT and a low threshold for hospitalization during acute infection with COVID-19," the authors write.

One author disclosed financial ties to the biopharmaceutical industry.

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