Impact of COVID-19 on Patients Supported with a Left Ventricular Assist Device.

Zakrzewski, Jack; Coyle, Laura; Aicher, Tracy; Chickerillo, Krystina; Gallagher, Colleen; Kuper, Katelyn; Sciamanna, Chris; Chau, Vinh Q; Tatooles, Antone

Patients on left ventricular assist device (LVAD) support may be susceptible to severe disease and complications from Coronavirus Disease-19 (COVID-19). The purpose of this study was to describe the clinical course of COVID-19 in LVAD patients. A retrospective review was performed at our center; 28 LVAD patients who developed COVID-19 between March 2020 and March 2021, and six patients with a prior COVID-19 infection who underwent LVAD implantation, were identified and examined. Of the 28 patients, 9 (32%) died during the study period, 5 (18%) during their index hospitalization for COVID-19. Two patients (7%) presented with suspected pump thrombosis. In a non-adjusted binary regression logistic analysis, admission to the intensive care unit (ICU) (unadjusted odds-ratio 7.6 [confidence interval 1.2-48], P=0.03), and the need for mechanical ventilation (unadjusted odds-ratio 14 [confidence interval 1.3-159], P=0.03) were associated with mortality. The six patients who previously had COVID-19 and subsequently received a LVAD were on intra-aortic balloon pump and inotropic support at time of surgery. All six experienced a complicated and prolonged post-operative course. Three patients (50%) suffered from ischemic stroke, and there was one (17%) 30-day mortality. We observed an increased risk of morbidity and mortality in LVAD patients with COVID-19.