Transplant Recipient Characteristics in COVID vs Non COVID Cause of Death

PURPOSE: The purpose of this study is to compare patient characteristics of those who died from Covid-19 compared to death from all other causes. METHODS: The UNOS registry was queried to compare transplant recipients who died of Covid (n=300) vs non-Covid causes (n=5,644) from 2018 to 2021. Patient characteristics including age, sex, ethnicity, smoking, medical comorbidities, and time of transplant hemodynamics were evaluated. Baseline characteristics were compared using the Mann Whitney U test and Chi square test as appropriate. Survival was compared using Kaplan-Meier survival analysis. RESULTS: The population who died from Covid was significantly older (56.6y vs 49.8y, p <0.001), had a higher percentage of males (79.3% vs 74.3%, p=0.049), had a higher incidence of diabetes (39.1% vs 27.8%, p<0.001), increased incidence of smoking (53.7% vs 42% p<0.001), and had a higher cardiac output (4.7L/min vs 4.5L/min, p=0.032). Causians had significantly lower incidence of death from Covid (62.7% vs 67.2%, p=0.031). Donor age, waiting times, baseline renal function, ischemic times, and cardiopulmonary support time did not differ significantly between the two populations. CONCLUSION: Widely studied risk factors for Covid pneumonia mortality such as age, male sex, diabetes, and smoking were consistent in the post heart transplant population. Communities of color were disproportionately affected by Covid. Furthermore, Covid deaths were not associated with inferior cardiac characteristics at time of transplant. More investigation is warranted to investigate the effect of more widely available immunologic and pharmacological therapies on high-risk subpopulations following heart transplant.