COVID-19 in heart transplant recipients: A systematic review

The high mortality and morbidity rate of COVID-19 turned this pandemic into the most challenging health issue. Here we systematically reviewed the consequences of COVID-19 in heart transplant recipients.

The terms “Coronavirus” or “COVID19”, “SARS-CoV-2”, “Heart Transplantation”, and “Cardiac Graft” were searched focusing on heart transplant patients with positive severe acute respiratory syndrome of coronavirus-2 (SARS-CoV-2) on June 22, 2022, in Web of Science / ISI, PubMed and Ovid ProQuest, Scopus.

The results showed that of 14 eligible studies that were included in the systematic review, 8 were case reports, and 6 case series. Among 109 reported cases, 67 patients were male and 22 were female and about the rest, it was not reported. The minimum hospitalization day was one day and the maximum was 60 days. In three case reports, the studied patients died, and in one case series, 7 out of 28 patients died. The most reported symptoms were shortness of breath (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (7.7%). 66 percent).

Although the symptoms of the disease in these patients are similar to other patients, the mortality rate is high. Considering that the studies conducted on heart transplant recipients with covid-19 have mostly been in the form of case studies, it is suggested that larger studies be conducted so that more accurate information can be obtained regarding the survival rate, symptoms of the disease, and the type of drugs used.

Practical Implications:

 The mortality rate of heart transplant cases affected by COVID-19 was 23.6% (21 patients).In four studies the duration of hospitalization was not mentioned, but the others varied from no hospitalization in one case to up to 60 days. The most reported symptoms were dyspnea (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (66.7%). Treatment differed for each patient, but hydroxychloroquine, antibiotic therapy including Azithromycin, and lopinavir/ritonavir were the most commonly used drugs.