The COVID-19 Infection in Heart Transplant Recipients: A Cohort Study

Infectious diseases are major complications after solid organ transplantation. Heart transplant patients have a high mortality rate after Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection. Coronavirus disease 2019 (COVID‐19) vaccines have shown efficacy in generating specific immune response. This study aims to describe the COVID-19 infection before and after vaccination in heart transplant recipients.

This was a single-center cohort study including 95 heart transplant recipients with laboratory radiological confirmed COVID-19. 

COVID-19 infection was present before vaccination in 33 (35.78%) patients. The most frequent COVID-19 clinical presentations before vaccination were cough in 21 (63.63%) and myalgia in 19 (57.57%) patients; 12 (36.36%) were hospitalized; 17 (51.51%) cases had oxygen depletion and required supplemental oxygen; none of them needed invasive ventilation. Of the entire 33 COVID-19 patients, two patients (6.06%) re-experienced the disease about two months after complete vaccination and both of them were recovered. 63 heart transplant patients had not experienced COVID-19 before vaccination, of which 59 patients received vaccination. After two months, 23 vaccinated patients were infected with COVID-19 again, and 2 of the 3 patients who were not vaccinated were also infected. Five patients passed away in the whole study.

Heart transplant patients infected with SARS-CoV-2 are at greater risk of severe infection and death compared with immunocompetent individuals. Thus, COVID-19 vaccination for all HT recipients is of paramount importance.