Characteristics and Outcomes of COVID-19 in Patients on Left Ventricular Assist Device Support
Edo Y. Birati, Samer S. Najjar, Ryan J. Tedford, Brian A. Houston, Supriya Shore, Esther Vorovich, Pavan Atluri, Kimberly Urgo, María Molina, Susan Chambers, Nicole Escobar, Eileen Hsich, Jerry D. Estep, Kevin Alexander, Jeffrey J. Teuteberg, Sunit‐Preet Chaudhry, Ashwin Ravichandran, Adam D. DeVore, Kenneth B. Margulies, Thomas C. Hanff, Ross Zimmer, Arman Kilic, Joyce Wald, Himabindu Vidula, J. Martens, Emily A. Blumberg, Jeremy A. Mazurek, Anjali Owens, Lee R. Goldberg, Jesús Álvarez‐García, Donna Mancini, Noah Moss, Michael V. Genuardi
Abstract
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic continues to afflict millions of people worldwide. Patients with end-stage heart failure and left ventricular assist devices (LVADs) may be at risk for severe COVID-19 given a high prevalence of complex comorbidities and functional impaired immunity. The objective of this study is to describe the clinical characteristics and outcomes of COVID-19 in patients with end-stage heart failure and durable LVADs. METHODS: The Trans-CoV-VAD registry is a multi-center registry of LVAD and cardiac transplant patients in the United States with confirmed COVID-19. Patient characteristics, exposure history, presentation, laboratory data, course, and clinical outcomes were collected by participating institutions and reviewed by a central data repository. This report represents the participation of the first 9 centers to report LVAD data into the registry. RESULTS: A total of 40 patients were included in this cohort. The median age was 56 years (interquartile range, 46-68), 14 (35%) were women, and 21 (52%) were Black. Among the most common presenting symptoms were cough (41%), fever, and fatigue (both 38%). A total of 18% were asymptomatic at diagnosis. Only 43% of the patients reported either subjective or measured fever during the entire course of illness. Over half (60%) required hospitalization, and 8 patients (20%) died, often after lengthy hospitalizations. CONCLUSIONS: We present the largest case series of LVAD patients with COVID-19 to date. Understanding these characteristics is essential in an effort to improve the outcome of this complex patient population.