Patients After Orthotopic Heart Transplantation With COVID-19: Are We Fast Enough With Vaccinations?

• Published in: Transplantation proceedings Vol. 54; no. 4; pp. 897 - 900
• Main Authors: Kuczaj, Agnieszka, Przybyłowski, Piotr
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2022
• Subjects: Adult; Aged; COVID-19 - prevention & control; Heart Transplantation - adverse effects; Humans; Middle Aged; mRNA Vaccines; SARS-CoV-2; Vaccination; Vaccines, Synthetic
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2022.02.022

Patients after orthotopic heart transplantation (HTx) are especially susceptible to infections owing to permanent need for immunosuppression. Vaccinations against COVID-19 have been available since January 2021 and are recommended in organ recipients.
The aim of this study was to analyze COVID-19 susceptibility and mortality in HTx and number of patients with COVID-19 previously vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
We analyzed a whole cohort of 552 patients after HTx who were SARS-CoV-2 positive and remained under surveillance of the transplantation center during March 2020 to September 2021.
Among 552 patients after HTx, 10 were COVID-19 survivors prior to transplantation and 103 had SARS CoV-2 infection after transplantation.
Mean age of patients with COVID-19 was 55.6 (±14) years, and mean time from transplantation to SARS-CoV-2 infection was 2856 (±2596) days (range, 16-9569 days; interquartile range, 397-4763 days). Among the patients who were COVID-19 positive, 15 were asymptomatic, 10 died, and 51 infections occurred in the era of vaccinations.
In the group of patients who were positive for COVID-19 in 2021, 6 received only a single dose of the mRNA vaccine and 3 were vaccinated twice. Among the vaccinated patients with COVID-19, 2 died of severe COVID-19: 1 after a single dose and 1 after 2 standard doses of the vaccine.
We observed high susceptibility to SARS-CoV-2 infection in the group of patients after HTx. The majority of patients infected in 2021 did not received the vaccine. Vaccination does not fully protect against severe COVID-19 in patients after HTx.