Colleagues,We all devour research papers daily hungry for information about Covid-19 and transplant, but I believe that the ISHLT community must move quicker than that to save lives. Our hearts go out to our colleagues in China, Italy, South Korea and elsewhere who have borne the brunt of the pandemic thus far.
I would like to propose this thread for colleagues to post replies on the following topics (feel free to add)
PRESENTATION--- Chest xray initial pattern? Clinical tempo of deterioration. Only adults or do pediatric transplants develop significant illnessMANAGEMENT-- If a transplant "looks well" but has COVID-19-- do you admit? How often do these patients deteriorate and if so, is it sudden where they suffer by not being admitted?TREATMENT-- Experience with antivirals (beyond trials)--- Ganciclovir? Treating inflammation with Tociluzumab, chloroquine?Co-infection--- Does Influenza + or human metapneumovirus positive rule out COVID?IMMUNOSUPPRESSION--- In Kidney forums, some recommend steroid only immunosuppression which is not practical for heart patients. What are people doing? Higher steroid, or cutting steroid off, holding MMF? Perhaps TAC Monotherapy (my bias)Please share as we combat this terrible illness.
The NEJM article on Kaletra was not supportive of its use against COVID as opposed to the Hydroxychlorquine and azithromycin combo
Raymond L. Benza, MD, FACC
Professor and Director
Division of Cardiovascular Diseases
Bob and Corrine Frick Endowed Chair of Heart Failure
Department of Medicine
The Ohio State University Wexner medical Center
395 W 12th Ave
Columbus, Ohio 43210