COVID-19 among heart transplant recipients in Germany: a multicenter survey

Rivinius R, Kaya Z, Schramm R, Boeken U, Provaznik Z, Heim C, Knosalla C, Schoenrath F, Rieth A, Berchtold-Herz M, Barten MJ, Rauschning D, Mücke VT, Heyl S, Pistulli R, Grinninger C, Hagl C, Gummert JF, Warnecke G, Schulze PC, Katus HA, Kreusser MM, Raake PW (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Clinical Research in Cardiology Springer Verlag (Germany)

DOI: 10.1007/s00392-020-01722-w

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.

Authors with CRIS profile

Christian Heim Department of Cardiac Surgery

Involved external institutions

Universitätsklinikum Regensburg DE Germany (DE) Deutsches Herzzentrum Berlin DE Germany (DE) Universitäts-Herzzentrum Freiburg - Bad Krozingen GmbH DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Bundeswehrzentralkrankenhaus Koblenz DE Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE) Universitätsklinikum Münster DE Germany (DE) Klinikum der Universität München DE Germany (DE) Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK e.V.) DE Germany (DE) Universitätsklinikum Jena DE Germany (DE) Universitätsklinikum Heidelberg DE Germany (DE) Herz- und Diabeteszentrum Nordrhein-Westfalen DE Germany (DE) Universitätsklinikum Düsseldorf DE Germany (DE) Kerckhoff-Klinik DE Germany (DE)

How to cite

APA:

Rivinius, R., Kaya, Z., Schramm, R., Boeken, U., Provaznik, Z., Heim, C.,... Raake, P.W. (2020). COVID-19 among heart transplant recipients in Germany: a multicenter survey. Clinical Research in Cardiology. https://doi.org/10.1007/s00392-020-01722-w

MLA:

Rivinius, Rasmus, et al. "COVID-19 among heart transplant recipients in Germany: a multicenter survey." Clinical Research in Cardiology (2020).

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