Effects of Body Mass Index on Presentation and Outcomes of COVID-19 among Heart Transplant and Left Ventricular Assist Device Patients: A Multi-Institutional Study.
Publication/Presentation Date
1-1-2023
Abstract
The coronavirus disease 2019 (COVID-19) pandemic continues to pose a significant threat to patients receiving advanced heart failure therapies. The current study was undertaken to better understand the relationship between obesity and outcomes of SARS-CoV-2 infection in patients with a left ventricular assist device (LVAD) or heart transplant. We performed a retrospective review of patients with a heart transplant or LVAD who presented to one of the participating 11 institutions between April 1 and November 30, 2020. Patients were grouped by body mass index (BMI) into obese (BMI ≥ 30 k/m2) and nonobese cohorts (BMI < 30 kg/m2). Multivariable logistic regression models were used to estimate effects of obesity on outcomes of interest. Across all centers, 162 heart transplant and 81 LVAD patients were identified; 54 (33%) and 38 (47%) were obese, respectively. Obese patients tended to have more symptoms at presentation. No differences in rates of hospitalization or ICU admission were noted. Obese patients with LVADs were more likely to require mechanical ventilation (39% vs. 8%, p < 0.05). No differences in renal failure or secondary infection were noted. Mortality was similar among heart transplant patients (11% [obese] vs. 16% [nonobese], p = 0.628) and LVAD patients (12% vs. 15%, p = 1.0). BMI was not associated with increased adjusted odds of mortality, ICU admission, or mechanical ventilation (all p > 0.10). In summary, acute presentations of SARS-CoV-2 among heart transplant and LVAD recipients carry a significantly higher mortality than the general population, although BMI does not appear to impact this. Further studies on the longer-term effects of COVID-19 on this population are warranted.
Volume
69
Issue
1
First Page
43
Last Page
49
ISSN
1538-943X
Published In/Presented At
Iyengar, A., Cohen, W., Han, J., Helmers, M., Kelly, J. J., Patrick, W., Moss, N., Molina, E. J., Sheikh, F. H., Houston, B. A., Tedford, R. J., Shore, S., Vorovich, E. E., Hsich, E. M., Bensitel, A., Alexander, K. M., Chaudhry, S. P., Vidula, H., Kilic, A., Genuardi, M. V., … Atluri, P. (2023). Effects of Body Mass Index on Presentation and Outcomes of COVID-19 among Heart Transplant and Left Ventricular Assist Device Patients: A Multi-Institutional Study. ASAIO journal (American Society for Artificial Internal Organs : 1992), 69(1), 43–49. https://doi.org/10.1097/MAT.0000000000001801
Disciplines
Medicine and Health Sciences
PubMedID
36583770
Department(s)
Department of Surgery
Document Type
Article