Outcomes of COVID-19 in heart failure, LVAD, and heart transplant patients in an advanced heart failure practice

Susan George; Luke C Cunningham; David P Nelson; Douglas A Horstmanshof; James W Long; Ahmed M El Banayosy

doi:10.1016/j.ahjo.2022.100223

Outcomes of COVID-19 in heart failure, LVAD, and heart transplant patients in an advanced heart failure practice

Am Heart J Plus. 2022 Dec:24:100223. doi: 10.1016/j.ahjo.2022.100223. Epub 2022 Nov 3.

Authors

Susan George¹, Luke C Cunningham¹, David P Nelson¹, Douglas A Horstmanshof¹, James W Long¹, Ahmed M El Banayosy¹

Affiliation

¹ INTEGRIS Advanced Cardiac Care, Nazih Zuhdi Transplant Institute, INTEGRIS Baptist Medical Center, Oklahoma City, OK 73112, United States of America.

Abstract

Background: Patients with heart failure face increased morbidity and mortality when infected with COVID-19. The objective of this study was to evaluate the outcomes of patients with Heart Failure (HF), Left Ventricular Assist Devices (LVADs), or Heart Transplants (HTx) diagnosed with COVID-19 within an advanced HF practice.

Methods: Out of 2635 patients followed, 96 patients were diagnosed with COVID-19 between March 2020 and January 2021. Median hospital length of stay (LOS), requirement for mechanical ventilation (MV), and mortality rate were evaluated.

Results: The distribution of COVID-19 among the 96 patients was: HF = 43 (45 %), LVAD = 16 (17 %) and HTx = 37 (38 %). Among 43 HF patients, 5 (12 %) died, 18 (42 %) required hospitalization with an LOS of 7 days, 5 (12 %) required ICU and 4 (9 %) required MV. Of the 16 LVAD patients, 2 (13 %) died, 8 (50 %) required hospitalization with an LOS of 11 days, 3 (19 %) required ICU and 3 (19 %) required MV. Among 37 HTx patients, 7 (19 %) died, 23 (62 %) required hospitalization with an LOS of 9 days, 6 (16 %) required ICU and 6 (16 %) required MV.

Conclusion: This report is among the first to describe the impact of COVID-19 on a diverse advanced HF practice. It highlights the risks associated with COVID-19 faced by the HF, LVAD and HTx patients. A 90-day mortality rate of 19 % with HTx patients acquiring COVID-19 is ominous as is a mortality rate of 12 % each for HF and LVAD patients. This clinical impact should serve as a reminder of unique challenges with these populations.

Keywords: ACC, American College of Cardiology; AHA, American Heart Association; COVID-19; COVID-19, Coronavirus Disease-2019; HF, Heart Failure; HF-C/D, Stage C or D Heart Failure; HTx, Heart Transplantation; Heart failure; Heart transplantation; LVAD; LVAD, Left Ventricular Assist Device; Mortality; Outcomes.