{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T09:11:43Z","timestamp":1709889103630},"reference-count":0,"publisher":"National Institute of Public Health NIH (National Research Institute)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Przegl Epidemiol"],"abstract":"<p><strong>ABSTRACT<\/strong><br \/><strong>INTRODUCTION.<\/strong> The study is a prospective clinical observation of patients after orthotopic heart\u00a0transplantation in a large academic medical center in relation to COVID-19 morbidity. The study population\u00a0was comprised of 552 patients. All patients were consulted and advised by telephone as regards the prophylaxis\u00a0of SARS-CoV-2 infection. Hospital and outpatient follow-ups were limited to the minimum. Preventive\u00a0modification of immunosuppression was not recommended in relation to the pandemic. Three patients with\u00a0multiple comorbidities (a woman aged 60, a man aged 59, and another man aged 83; 2.25 years, 5.5 years, and 7.5\u00a0years after heart transplantation, respectively) and one patient with concomitant arterial hypertension (a woman\u00a0aged 48, 5.5 years after heart transplantation) presented with a symptomatic COVID-19 infection. Three of\u00a0the patients were on tacrolimus immunosuppression, and both female patients were additionally on therapy\u00a0with mycophenolate mofetil, which was discontinued following the diagnosis of infection. One male patient\u00a0received combined therapy of cyclosporine A and mycophenolate mofetil. The 60-year-old woman presented\u00a0with gastrointestinal manifestations of the COVID-19 infection which were of moderate severity. The recovery\u00a0was achieved. The 59-year-old man presented with myocardial infarction, exacerbated renal insufficiency that\u00a0required hemodialysis and cardiorespiratory failure complicated by bacterial sepsis. As a result, the patient died.<br \/>The 83-year-old male patient reporting fever, myalgia, fatigue, cough and dyspnea was admitted to hospital\u00a0and deceased due to septic shock two days after admission. The 48-year old woman who presented with mild\u00a0symptoms of the upper respiratory tract infection recovered after two weeks. Symptomatic treatment was used in\u00a0all the patients. Another male patient (aged 45 years, 8 years after orthotopic heart transplant with no significant\u00a0comorbidities) was an asymptomatic carrier of SARS-CoV-2 and remained under hospital care.<br \/><strong>Conclusions:<\/strong> Of 552 patients after orthotopic heart transplantation, two SARS-CoV-2-related deaths were\u00a0reported.<\/p>\n<p><strong>STRESZCZENIE<\/strong><br \/>Praca jest prospektywn\u0105 obserwacj\u0105 kliniczn\u0105 zachorowalno\u015bci na COVID-19 w\u015br\u00f3d chorych po ortotopowym\u00a0przeszczepieniu serca pozostaj\u0105cych pod opiek\u0105 ambulatoryjn\u0105 du\u017cego o\u015brodka akademickiego. Badana populacja\u00a0obejmowa\u0142a 552 pacjent\u00f3w po ortotopowym przeszczepieniu serca. Wszystkim chorym udzielono teleporad\u00a0odno\u015bnie profilaktyki infekcji SARS-CoV2. Wizyty szpitalne i kontrole w poradni zosta\u0142y ograniczone\u00a0do niezb\u0119dnego minimum. Nie zalecano prewencyjnej modyfikacji farmakoterapii w zwi\u0105zku z pandemi\u0105.<br \/>U trzech chorych z licznymi chorobami wsp\u00f3\u0142istniej\u0105cymi (kobieta lat 60, m\u0119\u017cczyzna lat 59 oraz m\u0119\u017cczyzna lat\u00a083, odpowiednio 2,25, 5,5 i 7,5 lat po transplantacji) oraz u jednego pacjenta ze wsp\u00f3\u0142istniej\u0105cym nadci\u015bnieniem\u00a0t\u0119tniczym (kobieta lat 48, 5,5 lat po przeszczepieniu serca) wyst\u0105pi\u0142a objawowa infekcja. Trzech chorych otrzymywa\u0142o\u00a0immunosupresj\u0119 z\u0142o\u017con\u0105 takrolimusu w monoterapii, pacjentki otrzymywa\u0142y dodatkowo mykofenolan\u00a0mofetylu, kt\u00f3ry zosta\u0142 czasowo wstrzymany po rozpoznaniu infekcji. Jeden chory otrzymywa\u0142 terapi\u0119 z\u0142o\u017con\u0105\u00a0z cyklosporyny A i mykofenolanu mofetylu. U 60-letniej kobiety wst\u0105pi\u0142y objawy ze strony uk\u0142adu pokarmowego\u00a0o umiarkowanym nasileniu. Uzyskano wyzdrowienie. 59-letni m\u0119\u017cczyzna zosta\u0142 przyj\u0119ty z objawami\u00a0zawa\u0142u serca, zaostrzeniem przewlek\u0142ej choroby nerek, wymagaj\u0105cej dializoterapii oraz niewydolno\u015bci kr\u0105\u017ceniowo-oddechowej powik\u0142anej przez posocznic\u0119 bakteryjn\u0105; chory zmar\u0142. 83-letni chory zg\u0142aszaj\u0105cy gor\u0105czk\u0119,\u00a0b\u00f3le mi\u0119\u015bniowe, kaszel i duszno\u015b\u0107 zosta\u0142 przyj\u0119ty do szpitala i zmar\u0142 w objawach wstrz\u0105su septycznego dwa\u00a0dni po przyj\u0119ciu. 48-letnia chora prezentowa\u0142a \u0142agodne objawy ze strony g\u00f3rnych dr\u00f3g oddechowych, wyzdrowia\u0142a\u00a0po 2 tygodniach. U wszystkich chorych stosowano leczenie objawowe. U jednego chorego (45 lat, 8 lat\u00a0po transplantacji serca, bez istotnych chor\u00f3b wsp\u00f3\u0142istniej\u0105cych) stwierdzono bezobjawowe nosicielstwo SARSCoV-2, z obawy przed nag\u0142ym pogorszeniem pozostawa\u0142 pod opiek\u0105 szpitaln\u0105.<br \/><strong>Wnioski:<\/strong> Spo\u015br\u00f3d 552 chorych po ortotopowym przeszczepieniu serca odnotowano dwa zgony zwi\u0105zane\u00a0z SARS-CoV-2.<\/p><\/jats:p>","DOI":"10.32394\/pe.74.51","type":"journal-article","created":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T13:24:24Z","timestamp":1619184264000},"page":"596-605","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 morbidity in patients after orthotopic heart transplantation \u2013 single center clinical observation"],"prefix":"10.32394","volume":"74","author":[{"given":"A","family":"Kuczaj","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Ma\u0142yszek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Trzci\u0144ska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Zembala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Przyby\u0142owski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"17323","published-online":{"date-parts":[[2021,4,8]]},"container-title":["Przeglad Epidemiologiczny"],"original-title":["Zachorowalno\u015b\u0107 na COVID-19 wsr\u00f3d chorych po ortotopowym przeszczepieniu serca \u2013 obserwacja jednoo\u015brodkowa"],"link":[{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180966-101529","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180966-101529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T08:45:17Z","timestamp":1709887517000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/COVID-19-morbidity-in-patients-after-orthotopic-heart-transplantation-single-center,180966,0,2.html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,8]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020]]}},"alternative-id":["180966"],"URL":"https:\/\/doi.org\/10.32394\/pe.74.51","relation":{},"ISSN":["0033-2100","2545-1898"],"issn-type":[{"value":"0033-2100","type":"print"},{"value":"2545-1898","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,8]]}}}