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COVID-19 in Heart Transplant Recipients: A Multicenter Analysis of the Northern Italian Outbreak.
Bottio, Tomaso; Bagozzi, Lorenzo; Fiocco, Alessandro; Nadali, Matteo; Caraffa, Raphael; Bifulco, Olimpia; Ponzoni, Matteo; Lombardi, Carlo Maria; Metra, Marco; Russo, Claudio Francesco; Frigerio, Maria; Masciocco, Gabriella; Potena, Luciano; Loforte, Antonio; Pacini, Davide; Faggian, Giuseppe; Onorati, Francesco; Sponga, Sandro; Livi, Ugolino; Iacovoni, Attilio; Terzi, Amedeo; Senni, Michele; Rinaldi, Mauro; Boffini, Massimo; Marro, Matteo; Jorgji, Vjola; Carrozzini, Massimiliano; Gerosa, Gino.
Afiliación
  • Bottio T; Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy. Electronic address: tbottio@gmail.com.
  • Bagozzi L; Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
  • Fiocco A; Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
  • Nadali M; Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
  • Caraffa R; Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
  • Bifulco O; Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
  • Ponzoni M; Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
  • Lombardi CM; Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University, Cardiothoracic Department, Spedali Civili of Brescia, Brescia, Italy.
  • Metra M; Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University, Cardiothoracic Department, Spedali Civili of Brescia, Brescia, Italy.
  • Russo CF; Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, Niguarda Hospital, Milan, Italy.
  • Frigerio M; Transplant Cardiology Unit, Cardiac Thoracic and Vascular Department, Niguarda Hospital, Milan, Italy.
  • Masciocco G; Transplant Cardiology Unit, Cardiac Thoracic and Vascular Department, Niguarda Hospital, Milan, Italy.
  • Potena L; Cardiac, Thoracic, Vascular and Transplant Department, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
  • Loforte A; Cardiac, Thoracic, Vascular and Transplant Department, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
  • Pacini D; Cardiac, Thoracic, Vascular and Transplant Department, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
  • Faggian G; Division of Cardiac Surgery, Department of Surgery, University of Verona, Verona, Italy.
  • Onorati F; Division of Cardiac Surgery, Department of Surgery, University of Verona, Verona, Italy.
  • Sponga S; Cardiac Surgery Department, University of Udine, Udine, Italy.
  • Livi U; Cardiac Surgery Department, University of Udine, Udine, Italy.
  • Iacovoni A; Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy.
  • Terzi A; Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy.
  • Senni M; Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy.
  • Rinaldi M; Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy.
  • Boffini M; Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy.
  • Marro M; Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy.
  • Jorgji V; Hacohen Lab, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Carrozzini M; Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, Niguarda Hospital, Milan, Italy.
  • Gerosa G; Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
JACC Heart Fail ; 9(1): 52-61, 2021 01.
Article en En | MEDLINE | ID: mdl-33309578
ABSTRACT

OBJECTIVES:

The aim of this study was to assess the clinical course and outcomes of all heart transplant recipients affected by coronavirus disease-2019 (COVID-19) who were followed at the leading heart transplant centers of Northern Italy.

BACKGROUND:

The worldwide severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic has created unprecedented challenges for public health, demanding exceptional efforts for the successful management and treatment of affected patients. Heart transplant patients represent a unique cohort of chronically immunosuppressed subjects in which SARS-CoV-2 may stimulate an unpredictable clinical course of infection.

METHODS:

Since February 2020, we enrolled all 47 cases (79% male) in a first cohort of patients, with a mean age of 61.8 ± 14.5 years, who tested positive for SARS-CoV-2, out of 2,676 heart transplant recipients alive before the onset of the COVID-19 pandemic at 7 heart transplant centers in Northern Italy.

RESULTS:

To date, 38 patients required hospitalization while 9 remained self-home quarantined and 14 died. Compared to the general population, prevalence (18 vs. 7 cases per 1,000) and related case fatality rate (29.7% vs. 15.4%) in heart transplant recipients were doubled. Univariable analysis showed older age (p = 0.002), diabetes mellitus (p = 0.040), extracardiac arteriopathy (p = 0.040), previous PCI (p = 0.040), CAV score (p = 0.039), lower GFR (p = 0.004), and higher NYHA functional classes (p = 0.023) were all significantly associated with in-hospital mortality. During the follow-up two patients died and a third patient has prolonged viral-shedding alternating positive and negative swabs. Since July 1st, 2020, we had 6 new patients who tested positive for SARS-CoV-2, 5 patients asymptomatic were self-quarantined, while 1 is still hospitalized for pneumonia. A standard therapy was maintained for all, except for the hospitalized patient.

CONCLUSIONS:

The prevalence and mortality of SARS-CoV-2 should spur clinicians to immediately refer heart transplant recipients suspected as having SARS-CoV2 infection to centers specializing in the care of this vulnerable population.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Trasplante de Corazón / Pandemias / Receptores de Trasplantes / COVID-19 / Insuficiencia Cardíaca Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: JACC Heart Fail Año: 2021 Tipo del documento: Article
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Trasplante de Corazón / Pandemias / Receptores de Trasplantes / COVID-19 / Insuficiencia Cardíaca Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: JACC Heart Fail Año: 2021 Tipo del documento: Article