COVID‐19 infection in patients with history of pediatric heart transplant in Germany, Austria, and Switzerland

Abstract

COVID‐19 is a heterogenous infection—asymptomatic to fatal. While the course of pediatric COVID‐19 infections is usually mild or even asymptomatic, individuals after adult heart transplantation are at high risk of a severe infection. We conducted a retrospective, multicenter survey of 16 pediatric heart transplant centers in Germany, Austria and Switzerland to evaluate the risk of a severe COVID‐19 infection after pediatric heart transplantation between 02/2020 and 06/2021. Twenty‐six subjects (11 male) with a median age of 9.77 years at time of transplantation and a median of 4.65 years after transplantation suffered from COVID‐19 infection. The median age at time of COVID‐10 infection was 17.20 years. Fourteen subjects had an asymptomatic COVID‐19 infection. The most frequent symptoms were myalgia/fatigue (n = 6), cough (n = 5), rhinitis (n = 5), and loss of taste (n = 5). Only one subject showed dyspnea. Eleven individuals needed therapy in an outpatient setting, four subjects were hospitalized. One person needed oxygen supply, none of the subjects needed non‐invasive or invasive mechanical ventilation. No specific signs for graft dysfunction were found by non‐invasive testing. In pediatric heart transplant subjects, COVID‐19 infection was mostly asymptomatic or mild. There were no SARS‐CoV‐2 associated myocardial dysfunction in heart transplant individuals.