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  • 1
    In: Clinical Transplantation, Wiley, Vol. 35, No. 9 ( 2021-09)
    Abstract: The coronavirus disease 2019 (COVID‐19) pandemic represents a major concern in immunosuppressed patients such as heart transplant recipients. Therefore, we performed a systematic review to summarize the clinical features, treatment, and outcomes of heart transplant recipients with COVID‐19. We searched electronic databases from inception to January 11, 2021. Thirty‐nine articles (22 case reports and 17 cohorts) involving 415 patients were included. The mean age was 59.9 ± 15.7 years and 77% of patients were men. In cohort studies including outpatients and inpatients, the hospitalization rate was 77%. The most common symptoms were fever (70%) and cough (67%). Inflammatory biomarkers (C‐reactive protein and procalcitonin) were above the normal range. Forty‐eight percent of patients presented with severe or critical COVID‐19. Hydroxychloroquine (54%), azithromycin (14%), and lopinavir/ritonavir (14%) were the most commonly used drugs. Forty‐nine percent of patients discontinued the baseline regimen of antimetabolites. In contrast, 59% and 73% continued the same regimen of calcineurin inhibitors and corticosteroids, respectively. Short‐term mortality among cohorts limited to inpatients was 25%. Our review suggests that heart transplant recipients with COVID‐19 exhibited similar demographic and clinical features to the general population. However, the prognosis was poor in these patients.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2739458-X
    detail.hit.zdb_id: 2004801-4
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  • 2
    In: Clinical Cardiology, Wiley, Vol. 46, No. 8 ( 2023-08), p. 853-865
    Abstract: We assessed the effects of hypertonic saline solution (HSS) plus furosemide versus furosemide alone in patients with acute decompensated heart failure (ADHF). We searched four electronic databases for randomized controlled trials (RCTs) until June 30, 2022. The quality of evidence (QoE) was assessed using the GRADE approach. All meta‐analyses were performed using a random‐effects model. A trial sequential analysis (TSA) was also conducted for intermediate and biomarker outcomes. Ten RCTs involving 3013 patients were included. HSS plus furosemide significantly reduced the length of hospital stay (mean difference [MD]: −3.60 days; 95% confidence interval [CI] : −4.56 to −2.64; QoE: moderate), weight (MD: −2.34 kg; 95% CI: −3.15 to −1.53; QoE: moderate), serum creatinine (MD: −0.41 mg/dL; 95% CI: −0.49 to −0.33; QoE: low), and type‐B natriuretic peptide (MD: −124.26 pg/mL; 95% CI: −207.97 to −40.54; QoE: low) compared to furosemide alone. HSS plus furosemide significantly increased urine output (MD: 528.57 mL/24 h; 95% CI: 431.90 to 625.23; QoE: moderate), serum Na + (MD: 6.80 mmol/L; 95% CI: 4.92 to 8.69; QoE: low), and urine Na + (MD: 54.85 mmol/24 h; 95% CI: 46.31 to 63.38; QoE: moderate) compared to furosemide alone. TSA confirmed the benefit of HSS plus furosemide. Due to the heterogeneity in mortality and heart failure readmission, meta‐analysis was not performed. Our study shows that HSS plus furosemide, compared to furosemide alone, improved surrogated outcomes in ADHF patients with low or intermediate QoE. Adequately powered RCTs are still needed to assess the benefit on heart failure readmission and mortality.
    Type of Medium: Online Resource
    ISSN: 0160-9289 , 1932-8737
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2048223-1
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