COVID-19 among heart transplant recipients in Germany: a multicenter survey Rivinius, Rasmus Kaya, Ziya Schramm, René Boeken, Udo Provaznik, Zdenek Heim, Christian Knosalla, Christoph Schoenrath, Felix Rieth, Andreas Berchtold-Herz, Michael Barten, Markus J. Rauschning, Dominic Mücke, Victoria T. Heyl, Stephan Pistulli, Rudin Grinninger, Carola Hagl, Christian Gummert, Jan F. Warnecke, Gregor Schulze, P. Christian Katus, Hugo A. Kreusser, Michael M. Raake, Philip W. article article article Text https://doi.org/10.1007/s00392-020-01722-w https://nbn-resolving.org/urn:nbn:de:gbv:27-dbt-20230514-232021-001 https://www.db-thueringen.de/receive/dbt_mods_00057117 https://www.db-thueringen.de/receive/dbt_mods_00057117 doc-type:Article ScholarlyArticle ddc:610 COVID-19 Heart transplantation Immunosuppression Mortality 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. 2020-12 9 Seiten eng Clinical Research in Cardiology -- 1861-0684 -- 1861-0692 https://creativecommons.org/licenses/by/4.0/ public info:eu-repo/semantics/openAccess