Heart Transplant Recipients with Confirmed 2019 Novel Coronavirus Infection: The Detroit Experience.

Al-Darzi, Waleed; Aurora, Lindsey; Michaels, Alexander; Cowger, Jennifer; Grafton, Gillian; Selektor, Yelena; Tita, Cristina; Hannawi, Bashar; Lanfear, David; Nemeh, Hassan W; Williams, Celeste T

A chronic immunosuppressed state as in solid organ transplant recipients is a reported risk factor for the novel 2019 coronavirus infection. Patients with a history of orthotopic heart transplant (OHT) at a tertiary care transplant center in Detroit, Michigan were retrospectively reviewed from March until May 2020. Clinical parameters and outcomes of 5 OHT recipients and one combined heart-lung recipient with confirmed SARS-CoV-2 were obtained. The cohort was predominately African American males with median age of 59 years (Interquartile Range, 48.25-73.25). All patients were classified as having mild-moderate disease; none required intubation or ICU admission with no deaths. The most common presenting symptoms were fever and shortness of breath 83% (n=5), followed by cough and chills 67% (n=4). All admitted patients (n=5) received hydroxychloroquine and 3 received high dose steroids. Antimetabolites were held for 2 patients (33.3%). The calcineurin inhibitor trough goal was decreased in only 1 patient; 3 other patients, without change in goal, required calcineurin inhibitor dosage reduction. Two patients requiring readmission presented 7 and 23 days after initial symptoms onset. In conclusion, our experience with OHT patients infected by the SARS-CoV-2 virus did not have an elevated risk of severe infection. Impact of modifying immunosuppression remains unclear.