COVID-19 vaccination reduces infection, hospitalization and mortality in heart transplant recipients: JAMA

USA: Patients who have received an orthotopic heart transplant (OHT) and are infected with SARS-CoV-2 are at a higher risk of severe illness and mortality than immunocompetent patients, says an article published in the Journal of American Medical Association.

Further, the researchers showed that COVID-19 vaccination appears to be safe and is associated with a lower risk of COVID-19 infection, hospitalization, and death despite a lower immunogenic response to COVID-19 vaccination. The findings suggest that it is imperative that all heart transplant recipients obtain the COVID-19 vaccine.

Following SARS-CoV-2 infection, orthotopic heart transplant patients are at an elevated risk of morbidity and death. Although the antibody response to COVID-19 immunization is lower in solid organ transplant patients, no study has been conducted to investigate the safety and efficacy of COVID-19 vaccination in OHT recipients. As a result, Laura L. Peters and colleagues did this research. To investigate the safety and efficacy of COVID-19 immunization, as well as its links to SARS-CoV-2 contamination and clinical outcomes in a large group of adult OHT patients.

This case-control research looked at data from a single heart transplant program in the United States for all adult OHT patients who were followed up from January 15, 2021, to January 31, 2022. The main result was the number of SARS-CoV-2 infections and accompanying hospitalizations, intensive care unit (ICU) admissions, and fatalities among adult OHT patients who had been vaccinated vs those who had not been immunized.

The key findings of this study were as follows:

1. In the research, 436 individuals who had OHT were included, with 106 of them infected with COVID-19.

2. The mean age was 54 (17 years), with 303 (69.5%) males and 133 (30.5%) women.

3. In the vaccinated group, there were 366 patients, with 72 COVID-19 infections (19.7%), 15 hospitalizations (4.1%), 4 ICU stays (1.1%), and 3 fatalities (0.8% ).

4. In the unvaccinated group, there were 70 patients, with 34 COVID-19 infections (48.6%), 10 hospitalizations (14.3%), 3 ICU stays (4.3%), and 3 fatalities (4.3%).

5. COVID-19 vaccine was linked to a decreased risk of infection, hospitalization, and mortality from COVID-19.

6. At 6 months after receiving the COVID-19 vaccination, there was no echocardiographic indication of graft malfunction, clinically severe rejection, or allosensitization among the 366 vaccinated OHT patients.

In conclusion, COVID-19 immunization for all OHT patients is critical in light of more infectious COVID-19 variations and sustained high rates of transmission.

Reference:

Peters LL, Raymer DS, Pal JD, Ambardekar AV. Association of COVID-19 Vaccination With Risk of COVID-19 Infection, Hospitalization, and Death in Heart Transplant Recipients. JAMA Cardiol. Published online April 27, 2022. doi:10.1001/jamacardio.2022.0670