Long COVID-19 in Heart Transplant Recipients

PURPOSE: The goal of this study was to assess the frequency and common symptoms of post-acute COVID-19 syndrome (Long COVID-19) in heart transplant recipients (HTR). METHODS: After obtaining IRB approval, we conducted telephone surveys of HTR (n=30) who had tested positive for SARS-CoV-2 to evaluate their experience with acute COVID-19 illness and assess symptoms of Long COVID-19. Symptoms at onset and also beyond 6, 12, and 24 weeks of the initial diagnosis were recorded. Additionally, medical charts were reviewed for detailed information regarding transplant history, immunosuppression, COVID-19 management and hospitalization, and COVID-19 vaccination status. RESULTS: As noted in Table 1, among the 30 participants, 10 (33%) had symptoms consistent with Long COVID-19. Those with Long COVID-19 were more symptomatic during acute illness, with 40% of patients reporting cough, fevers or chills, and headaches, compared with 15%, 25%, and 20% respectively in those without Long COVID-19. Emergency department visits at initial illness (80% vs. 20%) and admission to the intensive care unit were more frequent (60% vs. 5%) in the Long COVID-19. Symptoms of Long COVID-19 lasted for a median of 9 weeks with 30% reporting ongoing symptoms at week 24. The most common persistent symptoms were depression, confusion, and difficulty concentrating. CONCLUSION: This study is an early investigation of a complex syndrome of Long COVID-19 in transplant patients. Long COVID-19 is not well described in the transplant setting. HTR at our center with Long COVID-19 were sicker at their initial COVID-19 diagnosis and had more emergency room visits, hospital admissions, and longer hospital stays than those without subsequent Long COVID-19. Although, recall bias could affect participants’ ability to remember details and symptoms, this would have impacted both groups similarly as the time since COVID-19 diagnosis to study enrollment was similar between the two groups. These are preliminary findings and the study is currently ongoing.