Background:
The coronavirus disease 2019 (COVID-19) pandemic continues to afflict millions of people worldwide. Patients with end-stage heart failure and left ventricular assist devices (LVADs) may be at risk for severe COVID-19 given a high prevalence of complex comorbidities and functional impaired immunity. The objective of this study is to describe the clinical characteristics and outcomes of COVID-19 in patients with end-stage heart failure and durable LVADs.
Methods:
The Trans-CoV-VAD registry is a multi-center registry of LVAD and cardiac transplant patients in the United States with confirmed COVID-19. Patient characteristics, exposure history, presentation, laboratory data, course, and clinical outcomes were collected by participating institutions and reviewed by a central data repository. This report represents the participation of the first 9 centers to report LVAD data into the registry.
Results:
A total of 40 patients were included in this cohort. The median age was 56 years (interquartile range, 46–68), 14 (35%) were women, and 21 (52%) were Black. Among the most common presenting symptoms were cough (41%), fever, and fatigue (both 38%). A total of 18% were asymptomatic at diagnosis. Only 43% of the patients reported either subjective or measured fever during the entire course of illness. Over half (60%) required hospitalization, and 8 patients (20%) died, often after lengthy hospitalizations.
Conclusions:
We present the largest case series of LVAD patients with COVID-19 to date. Understanding these characteristics is essential in an effort to improve the outcome of this complex patient population.
The aluminum chloride catalyzed chlorination of pentaborane(9) produces l-chloropentaborane(9) in high yield. Reversible isomerization of 1-chloroto 2-chloropentaborane(9) occurs readily in ether solution. The aluminum chloride catalyzed chlorination of 2-chloropentaborane(9) produces the first example of a dihalopentaborane(9), l,2-dichloropentaborane(9), in good yield. This material isomerizes in the presence of hexamethylenetetramine to produce what appears to be an inseparable mixture of 2,3-and 2,4-dichloropentaborane(9).Until recently there had been little interest in the direct chlorination of pentaborane(O), B5H9-a lack no doubt partially attributable to the report that attempted chlorinations of 9 in carbon disulfide solution resulted in explosions.1The successful preparation of 2-chloropentaborane (9), 2-CIBóHs, by the high-temperature reaction of 1bromopentaborane( 9) with aluminum chloride2 established the stability of a boron-chlorine bond in a higher borane system and prompted us to reinvestigate the direct chlorination of 9.Subsequently we found that 9 reacts smoothly with chlorine in boron trichloride solution at low temperatures, when catalyzed by aluminum chloride, to produce 1-chloropentaborane, 1-C1B5H8, in high yield.3 Attempts to chlorinate 9 in the absence of aluminum chloride result in low yields (10-30%) of 2-C1BóHs and only traces of 1-01 8. Similar low Contribution from the Department of Chemistry,
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