Heart transplant

Pediatric Heart Transplant Society’s First Report on COVID-19 Infections in Pediatric Heart Transplant Applicants and Recipients

This article was originally published here

Heart and Lung Transplant J. November 19, 2021: S1053-2498 (21) 02582-1. doi: 10.1016 / j.healun.2021.11.003. Online ahead of print.

ABSTRACT

BACKGROUND: Reports focused on adult heart transplant (HTx) recipients with COVID-19, however, suggest an increased risk of serious illness; it is not clear whether this is true for pediatric HTx patients, given the generally milder course of the disease in children generally with COVID-19. We sought to rapidly implement a multi-center data collection system on pediatric HTx candidates and recipients, with the aim of describing the patient population and infection outcomes.

METHODS: The Pediatric Heart Transplant Society (PHTS) is a multi-center collaboration that aims to improve outcomes for children who are identified and undergo HTx. The company consists of HTx pediatric centers in North America (n = 53), UK (n = 2) and Brazil (n = 1). In response to the pandemic, PHTS has developed a web-based platform to collect COVID-19 specific data on pediatric HTx candidates and recipients. Non-PHTS centers were also invited to submit data. Data fields included patient characteristics before and after HTx, suspected infection versus documented infection, need for hospitalization (including intensive care and ventilator use), treatments administered and the results at 30 days (resolution, death, sequelae and / or unresolved) RESULTS: Data collection started on 04/30/20. As of 03/15/21, there were 225 patients [19 pre-HTx and 206 post-HTx, median age 14 years (IQR 7, 18)] reported from 41 centers. Hospitalization occurred in 42% (n = 8) of pre-HTx patients and 21% (n = 43) of post-HTx patients. Of the patients listed for HTx, 21% (n = 4) required intensive care and 10.5% (n = 2) were mechanically ventilated. Among post-HTx patients, 7% (n = 14) required intensive care and 1% (n = 3) were mechanically ventilated. At 30 days, the majority of patients had symptom resolution (94.7% pre-HTx, 95.6% post-HTx). One death has been reported in a post-HTx patient before 30 days after the onset of COVID-19 disease.

CONCLUSIONS: These data demonstrate the ability to rapidly adapt the PHTS data collection infrastructure in response to a new infection and represent the first known multicenter report on characteristics and early outcomes for patients identified and following pediatric HTx with COVID -19. Hospitalization appears to be more frequent for applicants and recipients due to COVID-19 than for the general pediatric population, although stays have been short and mortality minimal.

PMID:34903451 | DO I:10.1016 / j.healun.2021.11.003


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