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

Amit Iyengar*, William Cohen, Jason Han, Mark Helmers, John J. Kelly, William Patrick, Noah Moss, Ezequiel J. Molina, Farooq H. Sheikh, Brian A. Houston, Ryan J. Tedford, Supriya Shore, Esther E. Vorovich, Eileen M. Hsich, Albatoul Bensitel, Kevin M. Alexander, Sunit Preet Chaudhry, Himabindu Vidula, Arman Kilic, Michael V. GenuardiEdo Y. Birati, And Pavan Atluri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)43-49
Number of pages7
JournalASAIO Journal
Volume69
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • COVID-19
  • LVAD
  • MCS
  • SARS-CoV-2
  • transplant

ASJC Scopus subject areas

  • Bioengineering
  • Biophysics
  • Biomedical Engineering
  • Biomaterials

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