Consequences of Covid-19 in cardiac transplant patients: Systematic review study

Abstract

Considering the conflicting results of studies regarding the consequences of covid-19 in heart recipients and the lack of a specific plan for the management of covid-19 in these patients, we decided to conduct a systematic review in this regard. To reach a general conclusion about the consequences and treatment of these patients and to use the results in the management of these patients at the world level. Therefore, this study was designed with the aim of investigating the consequences of contracting covid-19 in heart transplant recipients Methods: This research was a systematic review study that was conducted with the aim of investigating the consequences of contracting COVID-19 in heart transplant patients. For this purpose, databases were searched for articles related to heart transplant and covid-19. In this study, the basic search strategy in databases with keywords: "Heart transplantation" AND "COVID-19" OR "2019-nCoV" OR "2019-CoV" OR"SARS-nCoV-2". For Persian information, due to the low capabilities of these databases, no special search strategy was used and only searching by keywords was limited. First, the articles were evaluated based on the date of publication from the desired databases using the keywords mentioned by two evaluators using the JBI checklist, and the cases of disagreement between the two evaluators were referred to a third person. The selected articles were thoroughly studied and reviewed, and the required information was extracted and summarized using the designed table (extraction table) in the Excel software environment of Microsoft Office 20 series. Endnote X5 resource management software was used to organize, read titles and abstracts, and identify duplicates. Descriptive statistics (prevalence and percentage) were used to report cases related to gender, hospitalization days, and mortality rate. In order to perform statistical analyzes related to quantitative data in case report studies, mean (standard deviation) and Independent Samples Test were used in SPSS/Ver24 software. Results: The results of the present study showed that 14 studies that were included in the systematic review were 8 case report studies and 6 case report studies (case series). In terms of the quality of the studies, all the studies scored higher than the average (50% answered "yes" to the questions) and no studies were excluded from the study due to low quality. 67 patients were male and 22 were female. The average age of male patients (10.67) was 59.9 and female patients (24.98) was 45.12 years. The results of the Independent Samples Test statistical analysis showed that there was no statistically significant difference between the age of patients based on gender (P=0.152). A total of 89 patients who entered the statistical analysis, 21 cases of death (23.6%) were reported in heart transplant patients. The number of hospitalization days of patients was reported in 11 studies, the minimum hospitalization days were one day and the maximum hospitalization days were 60 days. In three case report studies, the studied patients died, and in one study, 7 out of 28 studied patients died. In only three articles, pulmonary complications are mentioned, and the patients required mechanical ventilation. The most reported symptoms were: shortness of breath (85.7%), cough (76.2%) and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (7.7%). 66 percent) was in the ranks. Few patients had diarrhea (28.6%) or pain (23.8%). Also, in the saved patients, there were no signs of transplant rejection and the function of the transplanted heart was normal.