Sharma Shriya, Ruiz Jose, Goswami Rohan
Division of Heart Failure and Transplant, Mayo Clinic, Jacksonville, FL.
Division of Heart Failure and Transplantation, Tampa General Hospital, Tampa, FL.
Mayo Clin Proc Innov Qual Outcomes. 2024 Apr 26;8(3):241-248. doi: 10.1016/j.mayocpiqo.2024.03.006. eCollection 2024 Jun.
To assess the effect of coronavirus disease 2019 (COVID-19) infection on heart transplant recipients requiring immunotherapy. To investigate the effectiveness of vaccination in immunosuppressed heart transplant recipients during the initial years of the COVID-19 pandemic, and to examine the timing of COVID-19 infections in heart transplant recipients' posttransplantation.
International data on COVID-19 infection in immunosuppressed populations is limited. Heart transplant recipients requiring immunotherapy are at risk for increased complications with COVID-19 infection. The availability of vaccination and temporal trends in this population has not been well described. We report outcomes in immunosuppressed patients during the initial years of the COVID-19 pandemic from March 1, 2019, to October 31, 2021, at Mayo Clinic in Florida.
A total of 98 patients were reviewed, of which 49 were COVID-19-positive (CP), and 49 were negative (CN). The cohort was well matched, with a median age of 58 years (49-65 years) in both groups. Females consisted of 41% in the CP group and 18.4% in the CN group. Immunosuppression was not significantly different for CP or CN patients. The median time from transplant to CP was 384 days (237-677 days). The CN group's median follow-up after transplant was 947 days (737-1191 days). The CP hospitalization rate was 24% with only 1 death. More CP patients were vaccinated than the CN group (92% vs 78%, =.025).
Our study sheds light on COVID-19's effect on heart transplant recipients and vaccination in this population. Our findings suggest a potentially heightened infection risk within the first 1.5 years posttransplant, highlighting the need to optimize management strategies and vaccine efficacy in this vulnerable group.
评估2019冠状病毒病（COVID-19）感染对需要免疫治疗的心脏移植受者的影响。调查在COVID-19大流行最初几年中免疫抑制的心脏移植受者接种疫苗的有效性，并研究心脏移植受者移植后COVID-19感染的时间。
免疫抑制人群中关于COVID-19感染的国际数据有限。需要免疫治疗的心脏移植受者感染COVID-19后并发症增加的风险较高。该人群中疫苗接种情况和时间趋势尚未得到充分描述。我们报告了2019年3月1日至2021年10月31日在佛罗里达州梅奥诊所的COVID-19大流行最初几年中免疫抑制患者的结局。
共审查了98例患者，其中49例为COVID-19阳性（CP），49例为阴性（CN）。两组队列匹配良好，两组的中位年龄均为58岁（49 - 65岁）。CP组女性占41%，CN组女性占18.4%。CP或CN患者的免疫抑制情况无显著差异。从移植到CP的中位时间为384天（237 - 677天）。CN组移植后的中位随访时间为947天（737 - 1191天）。CP组的住院率为24%，仅1例死亡。接种疫苗的CP患者比CN组更多（92%对78%，P = 0.025）。
我们的研究揭示了COVID-19对心脏移植受者的影响以及该人群的疫苗接种情况。我们的研究结果表明，移植后1.5年内感染风险可能会升高，这突出了在这一弱势群体中优化管理策略和疫苗效力的必要性。
