Letter by Muller et al Regarding Article “Impact of COVID-19 on Patients Supported with a Left Ventricular Assist Device”

Response to Muller et al. Regarding “Impact of COVID-19 on Patients Supported with a Left Ventricular Assist Device”

“…At that stage, most recommended treatment protocols and medical therapies, including the use of vaccines and outpatient monoclonal antibody infusions, were not yet available. We agree with Muller et al , 1 that this may have created a selection bias for symptomatic LVAD patients with COVID-19, while vaccinated or asymptomatic patients with milder cases were not included in our cohort.…”

“…Despite the findings by Muller et al , 1 we believe that LVAD patients are at an increased risk of morbidity and mortality from COVID-19 due to an immunocompromised state, often in the setting of multiple underlying medical conditions, and physiologic (mal)adaptations due to the mechanical circulatory support of continuous flow devices. While there have been many systems-based changes throughout the pandemic including increased availability and convenience of rapid testing, more evidence-based guidelines for the tirage and treatment of patients, as well as the availability of vaccines, LVAD patients should continue to be closely monitored and more often treated aggressively with outpatient antiviral therapies as they become more readily available to avoid debilitating illness from COVID-19.…”

“…We would like to thank Muller et al 1 for their thoughtful letter and for sharing some of their data from the Netherlands regarding the impact of coronavirus disease 2019 (COVID-19) on patients with implanted left ventricular assist devices (LVADs).…”

“…Muller et al 1 described a population of LVAD patients that were younger, had less comorbid conditions, and a lower median body mass index (BMI), which likely contributed to their lower COVID-19–related hospitalization and mortality rates. Comparatively, our patient population was older (65 vs. 54 years of age), had more comorbid conditions (43% vs. 0% of diabetes), and a higher BMI (27 vs. 24 kg/m 2 ), with 29% of our patients having a BMI greater than or equal to 30 kg/m 2 .…”

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To the Editor:We would like to thank Muller et al 1 for their thoughtful letter and for sharing some of their data from the Netherlands regarding the impact of coronavirus disease 2019 (COVID-19) on patients with implanted left ventricular assist devices (LVADs).Muller et al 1 described a population of LVAD patients that were younger, had less comorbid conditions, and a lower median body mass index (BMI), which likely contributed to their lower COVID-19-related hospitalization and mortality rates. Comparatively, our patient population was older (65 vs. 54 years of age), had more comorbid conditions (43% vs. 0% of diabetes), and a higher BMI (27 vs. 24 kg/m 2 ), with 29% of our patients having a BMI greater than or equal to 30 kg/m 2 .

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