Table 1.
Selected Reports of COVID-19 Infection in Heart Transplant Recipients
| First Author (Ref. #) | Number of HT Cases | COVID-Specific Treatment | Changes to HT Immunosuppression | Additional Features |
|---|---|---|---|---|
| Fernandez-Ruiz et al. (54) | 4 | HCQ in 4 (100%) Lopinavir/ritonavir in 2 (50%) Interferon-β in 1 (25%) |
Cyclosporine held in 3 (75%) MMF held in 2 (50%) and continued in 2 (50%) Prednisone continued in 4 (100%) Tacrolimus continued in 1 (25%) |
All presented with fever, cough and abnormal chest imaging 2 patients had severe ARDS requiring intubation and ICU admission, one of whom died 2 other patients with mild courses requiring supplemental oxygen and were discharged home |
| Hsu et al. (67)∗ | 1 | HCQ, remdesivir vs. placebo as part of clinical trial | Continued tacrolimus and prednisone, MMF held | Presented with typical symptoms, found to have lymphopenia and inflammatory markers, discharged home on day 15 |
| Holzhauser et al. (68) | 2 | Patient #1: tocilizumab, IVIG, HCQ, lopinavir/ritonavir Patient #2: HCQ, methylprednisolone, therapeutic anticoagulation |
Patient #1: MPA discontinued, dose reduction of tacrolimus Patient #2: MMF discontinued |
Patient #1 developed hypoxic respiratory failure, multi-organ failure, and death. Patient #2 was discharged home. |
| Latif et. al. (56) | 28 | HCQ in 18 (78%) High-dose corticosteroids in 8 (47%) IL-6 antagonists in 6 (26%) |
MMF discontinued in 16 (70%) Calcineurin inhibitor dose reduced in 6 (26%) |
79% required hospitalization; 25% required mechanical ventilation; 25% in-hospital mortality with 4 patients remaining hospitalized at end of study |
| Li et al. (55) | 2 | Patient #1: ribavirin, IV ganciclovir, high dose corticosteroids, IVIG, oral moxifloxacin and arbidol Patient #2: IV ganciclovir, oral moxifloxacin and arbidol |
Tacrolimus and MMF held in 1 patient; no changes reported in other case | Mild disease courses; did not require ICU admission and both discharged home |
| Mathies et al. (69) | 1 | HCQ | MMF discontinued; sirolimus changed to tacrolimus | Presented with typical symptoms, did not require ICU admission, discharged on hospital day 12, repeat PCR testing negative |
ARDS = acute respiratory distress syndrome; COVID-19 = coronavirus 2019; HCQ = hydroxychloroquine; HT = heart transplantation; ICU = intensive care unit; IV = intravenous; IVIG = intravenous immunoglobulin; MPA = mycophenolic acid; MMF = mycophenolate mofetil; PCR = polymerase chain reaction.
∗
Heart-kidney recipient