PT Journal
AU Rivinius, R
   Kaya, Z
   Schramm, R
   Boeken, U
   Provaznik, Z
   Heim, C
   Knosalla, C
   Schoenrath, F
   Rieth, A
   Berchtold-Herz, M
   Barten, M
   Rauschning, D
   Mücke, V
   Heyl, S
   Pistulli, R
   Grinninger, C
   Hagl, C
   Gummert, J
   Warnecke, G
   Schulze, P
   Katus, H
   Kreusser, M
   Raake, P
TI COVID-19 among heart transplant recipients in Germany: a multicenter survey
SO Clinical Research in Cardiology
PD December
PY 2020
BP 1531
EP 1539
VL 109
IS 12
PU Springer
DI 10.1007/s00392-020-01722-w
WP https://www.db-thueringen.de/receive/dbt_mods_00057117
LA en
DE COVID-19; Heart transplantation; Immunosuppression; Mortality
SN 1861-0684
AB Abstract Aims Heart transplantation may represent a particular risk factor for severe coronavirus infectious disease 2019 (COVID-19) due to chronic immunosuppression and frequent comorbidities. We conducted a nation-wide survey of all heart transplant centers in Germany presenting the clinical characteristics of heart transplant recipients with COVID-19 during the first months of the pandemic in Germany. Methods and results A multicenter survey of all heart transplant centers in Germany evaluating the current status of COVID-19 among adult heart transplant recipients was performed. A total of 21 heart transplant patients with COVID-19 was reported to the transplant centers during the first months of the pandemic in Germany. Mean patient age was 58.6 ± 12.3 years and 81.0% were male. Comorbidities included arterial hypertension (71.4%), dyslipidemia (71.4%), diabetes mellitus (33.3%), chronic kidney failure requiring dialysis (28.6%) and chronic-obstructive lung disease/asthma (19.0%). Most patients received an immunosuppressive drug regimen consisting of a calcineurin inhibitor (71.4%), mycophenolate mofetil (85.7%) and steroids (71.4%). Eight of 21 patients (38.1%) displayed a severe course needing invasive mechanical ventilation. Those patients showed a high mortality (87.5%) which was associated with right ventricular dysfunction (62.5% vs. 7.7%; p  = 0.014), arrhythmias (50.0% vs. none; p  = 0.012), and thromboembolic events (50.0% vs. none; p  = 0.012). Elevated high-sensitivity cardiac troponin T- and N-terminal prohormone of brain natriuretic peptide were significantly associated with the severe form of COVID-19 ( p  = 0.017 and p  < 0.001, respectively). Conclusion Severe course of COVID-19 was frequent in heart transplanted patients. High mortality was associated with right ventricular dysfunction, arrhythmias, thromboembolic events, and markedly elevated cardiac biomarkers.
PI Berlin
ER