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.