Characteristics and Outcomes of COVID-19 in Patients on Left Ventricular Assist Device Support

Circ Heart Fail. 2021 Apr;14(4):e007957. doi: 10.1161/CIRCHEARTFAILURE.120.007957. Epub 2021 Apr 5.


Background: The coronavirus disease 2019 (COVID-19) pandemic continues to afflict millions of people worldwide. Patients with end-stage heart failure and left ventricular assist devices (LVADs) may be at risk for severe COVID-19 given a high prevalence of complex comorbidities and functional impaired immunity. The objective of this study is to describe the clinical characteristics and outcomes of COVID-19 in patients with end-stage heart failure and durable LVADs.

Methods: The Trans-CoV-VAD registry is a multi-center registry of LVAD and cardiac transplant patients in the United States with confirmed COVID-19. Patient characteristics, exposure history, presentation, laboratory data, course, and clinical outcomes were collected by participating institutions and reviewed by a central data repository. This report represents the participation of the first 9 centers to report LVAD data into the registry.

Results: A total of 40 patients were included in this cohort. The median age was 56 years (interquartile range, 46-68), 14 (35%) were women, and 21 (52%) were Black. Among the most common presenting symptoms were cough (41%), fever, and fatigue (both 38%). A total of 18% were asymptomatic at diagnosis. Only 43% of the patients reported either subjective or measured fever during the entire course of illness. Over half (60%) required hospitalization, and 8 patients (20%) died, often after lengthy hospitalizations.

Conclusions: We present the largest case series of LVAD patients with COVID-19 to date. Understanding these characteristics is essential in an effort to improve the outcome of this complex patient population.

Keywords: COVID-19; SARS-CoV-2; heart failure; hospitalization; outcomes research; ventricular assist device.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • COVID-19 / complications
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • COVID-19 / therapy
  • Comorbidity
  • Female
  • Heart Failure / epidemiology*
  • Heart Failure / mortality
  • Heart Failure / surgery*
  • Heart Ventricles
  • Heart-Assist Devices* / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Pandemics*
  • Registries
  • SARS-CoV-2 / isolation & purification
  • United States / epidemiology