Treatment of Pediatric Patients With COVID Infection After Heart Transplantation.

The COVID-19 pandemic that has been ongoing since the beginning of 2020 has forced health care into a difficult struggle for wellness and the lives of patients. International data and our observations show that the course of the disease in these patients is different than in the general population. Symptoms depend on the immunosuppression and severity of viremia. The period of viral replication is much longer. Our observations include 4 pediatric patients post heart transplant who became infected with the coronavirus. One patient was infected in the hospital during perioperative period. Two others required hospitalization because of the severity of symptoms, and 1 was treated on an outpatient basis. The applied treatment included the reduction of immunosuppression, low-molecular-weight heparin, amantadine or remdesivir, steroids, and supplementation with zinc and vitamins C and D. Based on the antigenic tests performed, we determined the period of active replication to be 3 to 8 weeks from the onset of the first symptoms.

Quality of life in patients with a subcutaneous vs. transvenous implantable cardioverter-defibrillator.

BACKGROUND: The implantable cardioverter-defibrillator (ICD) and subcutaneous ICD (S-ICD) are well-accepted life-saving devices for treating potentially lethal ventricular arrhythmia, but little is known about quality of life (QoL) in patients with S-ICD and ICD. AIMS: Our study aimed to compare QoL in patients with S-ICD and ICD. METHODS: All consecutive patients who had S-ICD implanted between October 2015 and September 2021 were included in the study. A cohort of transvenous ICD (TV-ICD) patients was matched to S-ICD subjects by sex, age, indications for the device, and type of prevention. All patients were requested to fulfill two standardized questionnaires to assess QoL: 36-Item Short Form Health Survey (SF-36) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) 6 months after device implantation. RESULTS: Patients with S-ICD (n = 49) and TV-ICD (n = 49) did not differ regarding baseline characteristics. There were no statistically significant differences between S-ICD and TV-ICD subgroup, both for mental and physical QoL assessed in SF-36 and MLHFQ (all P = NS). The median MLHFQ total score was 24 (9-41) for S-ICD and 28 (14-43) for TV-ICD (P = 0.83). The median total score for the SF-36 questionnaire was 62.5 (29-86) vs. 59 (38-77) for S-ICD and TV-ICD, respectively (P = 0.78). CONCLUSIONS: Quality of life after device implantation does not differ significantly between the groups of patients with subcutaneous and conventional implantable cardioverter-defibrillator.