BACKGROUND:

Long COVID is a condition characterized by long-term consequences persisting or appearing after the typical convalescence period of COVID-19. It may last several months but the duration is still matter of observation. The symptoms and the clinical manifestations are clinically heterogeneous including heart failure (HF) episodes. We describe a case series of 4 patients who had long COVID and evolved to heart transplantation (Tx) indication from January/2020 to February/2022.

DESCRIPTION:

Mean age was 38±9.5 years, 75% were male and 50% were Caucasian. The whole sample was admitted in NYHA IV functional class. None of the patients had more than one previous comorbidity. All had positive troponin, NT-ProBNP (20234±13373) and c-reactive protein (14,7±13,1). Mean time from COVID-19 infection to admission date was 150±113 days and mean time from admission date to outcome was 112±62,1 days. Mean Ejection Fraction (EF) was 17±3,7% and 75% used Intra-aortic balloon (IAB). Two patients underwent Tx (all still alive), one died prior to Tx and one is still in the waiting list. 75% of patients had thrombotic complications awaiting Tx and all transplant patients had treated cellular rejection and Cytomegalovirus infection (table).

CONCLUSION:

HF secondary to COVID-19 due to Long COVID can progress to refractoriness to clinical treatment and Tx is the therapy of choice, showing success, despite high mortality during waiting list.