Evolution of the impact of the COVID-19 pandemic on heart transplant recipients : Decreasing risk, improving perspective
© 2024 The Authors. Transplant Infectious Disease published by Wiley Periodicals LLC..
BACKGROUND AND METHODS: Heart transplant recipients (HTr) have a higher probability of suffer from severe coronavirus disease-2019 (COVID-19) in comparison to general population, but their risk has changed over the course of the pandemic in relation to various factors. We conducted a prospective study including all HTr at risk of COVID-19 in a tertiary center between February 2020 and October 2022. The aim was to analyze how the prognosis (incidence of pneumonia and mortality) of COVID-19 in HTr has evolved over time, contextualizing variants, vaccination, and other treatments.
RESULTS: Of 308 HTr included, 124 got the infection (39.2%). COVID and non-COVID HTr had similar baseline characteristics. COVID-19 patients with pneumonia had a poorer prognosis than those with less severe presentations, with a higher rate of hospitalization (93.3 vs. 14.1%, p < .001) and death (41.0 vs. 1.2%, p < .001). Multivariate analysis identified age ≥60 years (odds ratio [OR] 3.65, 95% confidence interval [CI] 1.16-11.49, p = .027), and chronic kidney disease ≥3a (OR 4.95, 95% CI 1.39-17.54, p = .014) as predictors of pneumonia. Two-dose vaccination (OR 0.20, CI 95% 0.05-0.72, p = .02) and early remdesivir administration (OR 0.17, CI 0.03-0.90, p = .037) were protective factors. Over the course of the pandemic considering three periods in the follow-up (prevaccination February-December 2020, postvaccination January-December 2021, and post early remdesivir indication January-October 2022), we observed a reduction in pneumonia incidence from 62% to 19% (p < .001); and mortality (from 23% to 4%, p < .001).
CONCLUSIONS: The prognosis of COVID-19 in HTr has improved over time, likely due to vaccination and early administration of remdesivir.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:26 |
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| Enthalten in: |
Transplant infectious disease : an official journal of the Transplantation Society - 26(2024), 2 vom: 11. Apr., Seite e14250 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
García, Juan Carlos López-Azor [VerfasserIn] |
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| Links: |
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| Themen: |
COVID‐19 |
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| Anmerkungen: |
Date Completed 12.04.2024 Date Revised 12.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/tid.14250 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a García, Juan Carlos López-Azor |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Evolution of the impact of the COVID-19 pandemic on heart transplant recipients |b Decreasing risk, improving perspective |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 The Authors. Transplant Infectious Disease published by Wiley Periodicals LLC. | ||
| 520 | |a BACKGROUND AND METHODS: Heart transplant recipients (HTr) have a higher probability of suffer from severe coronavirus disease-2019 (COVID-19) in comparison to general population, but their risk has changed over the course of the pandemic in relation to various factors. We conducted a prospective study including all HTr at risk of COVID-19 in a tertiary center between February 2020 and October 2022. The aim was to analyze how the prognosis (incidence of pneumonia and mortality) of COVID-19 in HTr has evolved over time, contextualizing variants, vaccination, and other treatments | ||
| 520 | |a RESULTS: Of 308 HTr included, 124 got the infection (39.2%). COVID and non-COVID HTr had similar baseline characteristics. COVID-19 patients with pneumonia had a poorer prognosis than those with less severe presentations, with a higher rate of hospitalization (93.3 vs. 14.1%, p < .001) and death (41.0 vs. 1.2%, p < .001). Multivariate analysis identified age ≥60 years (odds ratio [OR] 3.65, 95% confidence interval [CI] 1.16-11.49, p = .027), and chronic kidney disease ≥3a (OR 4.95, 95% CI 1.39-17.54, p = .014) as predictors of pneumonia. Two-dose vaccination (OR 0.20, CI 95% 0.05-0.72, p = .02) and early remdesivir administration (OR 0.17, CI 0.03-0.90, p = .037) were protective factors. Over the course of the pandemic considering three periods in the follow-up (prevaccination February-December 2020, postvaccination January-December 2021, and post early remdesivir indication January-October 2022), we observed a reduction in pneumonia incidence from 62% to 19% (p < .001); and mortality (from 23% to 4%, p < .001) | ||
| 520 | |a CONCLUSIONS: The prognosis of COVID-19 in HTr has improved over time, likely due to vaccination and early administration of remdesivir | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID‐19 | |
| 650 | 4 | |a SARS‐CoV‐2 | |
| 650 | 4 | |a heart transplantation | |
| 650 | 4 | |a organ transplantation | |
| 650 | 4 | |a remdesivir | |
| 650 | 4 | |a vaccination | |
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| 700 | 1 | |a Martín, Javier González |e verfasserin |4 aut | |
| 700 | 1 | |a López-Medrano, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Eixerés-Esteve, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez, Pedro Caravaca |e verfasserin |4 aut | |
| 700 | 1 | |a Bagudá, Javier de Juan |e verfasserin |4 aut | |
| 700 | 1 | |a López-Jiménez, Elena Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Arribas, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Delgado-Jiménez, Juan Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Carmena, María Dolores García-Cosío |e verfasserin |4 aut | |
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