COVID‐19 in heart transplant recipients—A seroprevalence survey

Abstract

The clinical spectrum of COVID‐19 in heart transplant recipients has not been fully defined, because asymptomatic and sub‐clinical cases are difficult to capture. Seroprevalence surveys are an important tool to identify not just cases that have come to clinical attention, but all previously infected recipients. We performed a seroprevalence survey of the adult heart transplant program at a large New York City Hospital System. A total of 232 (87% of recipients being followed) subjects were tested, of whom 37 (15.9%) were found to be previously infected. This is comparable to the overall rate of prior infection in the NYC metro area. Disease course tended to be more severe than in the general population; however, this was at least partially driven by traditional risk factors of age and comorbidities. Lastly, 9 of 10 recipients who were initially found to be PCR positive subsequently tested positive for antibodies, confirming the ability of this population to mount a humoral response. In conclusion, prevalence of COVID‐19 in heart transplant recipients on immunosuppression was comparable to that in the general population of NYC, and 90% of those with an initially positive viral swab developed antibodies. In those who are infected, disease course tends to be more severe.

Mucormycosis as SARS-CoV2 sequelae in kidney transplant recipients: a single-center experience from India

“…There is an extensive literature in the context of clinical profile and outcome of COVID-19 in SOT [14] including kidney [15][16][17], liver [18], lung [19], and heart [20,21]. Transplantation activity ceased around the world during the COVID-19 peak, but it is estimated that postponing transplantation will result in excess of deaths [22] and hence depending on the COVID-19 surge and available resources, the transplantation should be resumed.…”

“…Mild cases (73% vs 43%; p-value = 0.1) were higher and there were fewer cases (20% vs 9%; p-value = 0.69) with severe COVID-19 in post-COVID-19 mucormycosis. Among the laboratory profile, lymphopenia [12 (10-18) vs 20 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26); p-value = 0.15] and higher neutrophil-lymphocyte ratio [7 (4.6-8.3) vs 3.85 (3.3 -5.8); p-value = 0.5] was more associated with post-COVID-19 mucormycosis.…”

Humoral and cellular immune response after severe acute respiratory syndrome coronavirus 2 messenger ribonucleic acid vaccination in heart transplant recipients: An observational study in France

“…Solid-organ transplant recipients are among the groups for whom vaccination is a priority. The seroprevalence of COVID-19 was found to be comparable in HT patients and in the general population, suggesting comparable susceptibility ( 7 ). In heart transplant (HT) recipients, vaccination against COVID-19 is associated with a lower risk of infection [hazard ratio (RR), 0.41; 95% CI, 0.30–0.56], hospitalization (RR, 0.29; 95% CI, 0.14–0.61) and death (RR, 0.19; 95% CI, 0.05–0.82), with no transplantation-specific adverse events ( 8 , 9 ).…”

Severe COVID-19 by SARS-CoV-2 Lineage B.1.1.7 in Vaccinated Solid-Organ Transplant Recipients: New Preventive Strategies Needed to Protect Immunocompromised Patients

“…COVID-19 is a major concern in solid-organ transplant (SOT) recipients, which have a mortality rate of up to 20% [ 1 , 2 ], and a 30% increased risk of death or use of mechanical ventilation [ 3 ]. In particular, heart transplant recipients have a more severe clinical course compared with the general population [ 4 ] and an estimated fatality rate of 25% [ 5 ]. Although they seem to not be at a higher risk of transmission [ 4 ].…”

“…In particular, heart transplant recipients have a more severe clinical course compared with the general population [ 4 ] and an estimated fatality rate of 25% [ 5 ]. Although they seem to not be at a higher risk of transmission [ 4 ]. Some studies demonstrated that SOT recipients hospitalized with COVID-19 showed similar overall outcomes as hospitalized non-SOT recipients with other chronic conditions (obesity, diabetes, and hypertension), suggesting that chronic immunosuppression may not be an independent risk factor for poor outcomes in COVID-19 patients requiring hospitalization [ 6 ].…”