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The Effect of Body Mass Index on Presentation of COVID-19 amongst Heart Transplant Recipients: A Multi-Institutional Study

PURPOSE: Characteristics and outcomes of heart transplant (HT) recipients who contract coronavirus (SARS-CoV-2) have been poorly described. The current study was undertaken to better understand the risk obesity may pose in this patient population METHODS: A prospectively-maintained Trans-CoV-VAD Reg...

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Autores principales: Iyengar, A., Han, J.J., Helmers, M.R., Smood, B.F., Patrick, W.L., Kelly, J., Moss, N., Najjar, S.S., Houston, B.A., Tedford, R.J., Shore, S., Vorovich, E., Hsich, E., Alexander, K.M., Chaudhry, S., Vidula, H., Kilic, A., Genuardi, M.V., Birati, E.Y., Atluri, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979420/
http://dx.doi.org/10.1016/j.healun.2021.01.1792
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author Iyengar, A.
Han, J.J.
Helmers, M.R.
Smood, B.F.
Patrick, W.L.
Kelly, J.
Moss, N.
Najjar, S.S.
Houston, B.A.
Tedford, R.J.
Shore, S.
Vorovich, E.
Hsich, E.
Alexander, K.M.
Chaudhry, S.
Vidula, H.
Kilic, A.
Genuardi, M.V.
Birati, E.Y.
Atluri, P.
author_facet Iyengar, A.
Han, J.J.
Helmers, M.R.
Smood, B.F.
Patrick, W.L.
Kelly, J.
Moss, N.
Najjar, S.S.
Houston, B.A.
Tedford, R.J.
Shore, S.
Vorovich, E.
Hsich, E.
Alexander, K.M.
Chaudhry, S.
Vidula, H.
Kilic, A.
Genuardi, M.V.
Birati, E.Y.
Atluri, P.
author_sort Iyengar, A.
collection PubMed
description PURPOSE: Characteristics and outcomes of heart transplant (HT) recipients who contract coronavirus (SARS-CoV-2) have been poorly described. The current study was undertaken to better understand the risk obesity may pose in this patient population METHODS: A prospectively-maintained Trans-CoV-VAD Registry containing HT recipients at 11 participating institutions who presented with SARS-CoV-2 were reviewed. Presenting characteristics, hospitalization rates, ventilator & intensive care unit usage, and mortality were queried. Patients were grouped by body mass index (BMI) into obese (BMI≥30 k/m(2)) and non-obese cohorts (BMI<30 kg/m(2)). Comparisons between groups were made utilizing chi-squared, Fisher's exact, and Mann-Whitney U-tests. Multivariable logistic regression models were utilized RESULTS: Across all centers, 85 HT recipients who tested positive for SARS-CoV-2 were identified, of whom 26 (31%) were obese. Median time from HT to diagnosis was 4.6 (1.8-13.8) years. No differences in age (57 vs 60 p 0.85) or female gender (31% vs 24% p 0.5) were noted between obese and non-obese patients. On presentation, obese patients were more symptomatic with higher rates of cough (76% vs 48% p 0.02), dyspnea (62% vs 41% p 0.09), diarrhea (60% vs 35% p 0.03), and headache (35% vs 14% p 0.03). No differences in rates of admission (62% vs 64% p 0.8), ICU presentation (44% vs 35% p 0.6) or need for mechanical ventilation were noted (38% vs 22% p 0.2). More secondary infections were noted amongst obese patients (32% vs 13% p 0.04). On follow-up, mortality was similar between groups (12% vs 9% p 0.7). On multivariable modeling, BMI was not associated with increased adjusted odds of hospital/ICU admission or mechanical ventilation (p>0.10) CONCLUSION: Acute presentations of SARS-CoV-2 amongst HT recipients carry significantly higher mortality over the general population. Obesity appears to impact presenting symptoms and secondary infections, but does not strongly impact ICU requirements or mortality
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spelling pubmed-79794202021-03-23 The Effect of Body Mass Index on Presentation of COVID-19 amongst Heart Transplant Recipients: A Multi-Institutional Study Iyengar, A. Han, J.J. Helmers, M.R. Smood, B.F. Patrick, W.L. Kelly, J. Moss, N. Najjar, S.S. Houston, B.A. Tedford, R.J. Shore, S. Vorovich, E. Hsich, E. Alexander, K.M. Chaudhry, S. Vidula, H. Kilic, A. Genuardi, M.V. Birati, E.Y. Atluri, P. J Heart Lung Transplant (28) PURPOSE: Characteristics and outcomes of heart transplant (HT) recipients who contract coronavirus (SARS-CoV-2) have been poorly described. The current study was undertaken to better understand the risk obesity may pose in this patient population METHODS: A prospectively-maintained Trans-CoV-VAD Registry containing HT recipients at 11 participating institutions who presented with SARS-CoV-2 were reviewed. Presenting characteristics, hospitalization rates, ventilator & intensive care unit usage, and mortality were queried. Patients were grouped by body mass index (BMI) into obese (BMI≥30 k/m(2)) and non-obese cohorts (BMI<30 kg/m(2)). Comparisons between groups were made utilizing chi-squared, Fisher's exact, and Mann-Whitney U-tests. Multivariable logistic regression models were utilized RESULTS: Across all centers, 85 HT recipients who tested positive for SARS-CoV-2 were identified, of whom 26 (31%) were obese. Median time from HT to diagnosis was 4.6 (1.8-13.8) years. No differences in age (57 vs 60 p 0.85) or female gender (31% vs 24% p 0.5) were noted between obese and non-obese patients. On presentation, obese patients were more symptomatic with higher rates of cough (76% vs 48% p 0.02), dyspnea (62% vs 41% p 0.09), diarrhea (60% vs 35% p 0.03), and headache (35% vs 14% p 0.03). No differences in rates of admission (62% vs 64% p 0.8), ICU presentation (44% vs 35% p 0.6) or need for mechanical ventilation were noted (38% vs 22% p 0.2). More secondary infections were noted amongst obese patients (32% vs 13% p 0.04). On follow-up, mortality was similar between groups (12% vs 9% p 0.7). On multivariable modeling, BMI was not associated with increased adjusted odds of hospital/ICU admission or mechanical ventilation (p>0.10) CONCLUSION: Acute presentations of SARS-CoV-2 amongst HT recipients carry significantly higher mortality over the general population. Obesity appears to impact presenting symptoms and secondary infections, but does not strongly impact ICU requirements or mortality Published by Elsevier Inc. 2021-04 2021-03-20 /pmc/articles/PMC7979420/ http://dx.doi.org/10.1016/j.healun.2021.01.1792 Text en Copyright © 2021 Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle (28)
Iyengar, A.
Han, J.J.
Helmers, M.R.
Smood, B.F.
Patrick, W.L.
Kelly, J.
Moss, N.
Najjar, S.S.
Houston, B.A.
Tedford, R.J.
Shore, S.
Vorovich, E.
Hsich, E.
Alexander, K.M.
Chaudhry, S.
Vidula, H.
Kilic, A.
Genuardi, M.V.
Birati, E.Y.
Atluri, P.
The Effect of Body Mass Index on Presentation of COVID-19 amongst Heart Transplant Recipients: A Multi-Institutional Study
title The Effect of Body Mass Index on Presentation of COVID-19 amongst Heart Transplant Recipients: A Multi-Institutional Study
title_full The Effect of Body Mass Index on Presentation of COVID-19 amongst Heart Transplant Recipients: A Multi-Institutional Study
title_fullStr The Effect of Body Mass Index on Presentation of COVID-19 amongst Heart Transplant Recipients: A Multi-Institutional Study
title_full_unstemmed The Effect of Body Mass Index on Presentation of COVID-19 amongst Heart Transplant Recipients: A Multi-Institutional Study
title_short The Effect of Body Mass Index on Presentation of COVID-19 amongst Heart Transplant Recipients: A Multi-Institutional Study
title_sort effect of body mass index on presentation of covid-19 amongst heart transplant recipients: a multi-institutional study
topic (28)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979420/
http://dx.doi.org/10.1016/j.healun.2021.01.1792
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