COVID-19 in heart transplant patients: Case reports from Brazil
Clin. transplant;
35(8): 1-13, Aug. 2021. tab.
Artigo
em Inglês
| SES-SP, CONASS, SESSP-IDPCPROD, SES-SP | ID: biblio-1283696
ABSTRACT The COVID-19 pandemic continues, with a late hyperinflammatory phase. The immunosuppressive therapy used in heart transplant patients, in theory, could reduce inflammation thus benefitting patients with COVID-19. So far, however, there is still very little literature on this subject.
METHODS:
This is a single-center retrospective study. We described laboratory parameters and clinical outcomes from 11 heart transplant patients with COVID-19 assisted at Dante Pazzanese Institute of Cardiology between March and July 2020.RESULTS:
Patients with ages between 35 to 79 years, and heart transplantation occurred from 3 to 264 months. The main comorbidities were diabetes mellitus (9/11; 81.8%), hypertension (10/11; 90.9%), and chronic renal disease (6/11; 54.5%). Cyclosporine A was used in 10 (90.9%) patients, mycophenolate mofetil in 9 (81.8%), and mTOR inhibitor in 5 (45.5%). Fever and cough were observed in 8 (72.7%) patients, and dyspnea and gastrointestinal symptoms in 5 (45.5%). Lymphopenia was observed in 10 (90.9%) and thrombocytopenia in 5 (45.5%). The higher level of troponin associated with chest tomography above 50% infiltrates of ground-glass opacity (GGO) was observed in those with the worst outcomes. Nine patients needed intensive care, and hospital stay ranged from 4 to 21 days, with 2 (18.2%) patients requiring vasopressor drugs and mechanical ventilation, and three patients (27.3%) dying due to COVID-19 complications.CONCLUSION:
Heart transplant patients had the similar symptoms and outcomes as general population; immunosuppressive therapy seems not to have protected them. Patients who presented higher levels of troponin and D-dimer, associated to greater GGO pulmonary infiltrates had worse outcomes. More studies with larger cohorts may clarify immunosuppressive effects on COVID-19 outcomes.
Biblioteca responsável:
BR79.1
Texto completo
Similares
