Evidence map›Paper›PMID 41600794›Full record

Observational studyViruses2025

The Role of mTOR Inhibitors in COVID-19 Outcomes Among Heart Transplant Recipients.

Agnieszka Kuczaj, Szymon Warwas, Mikołaj Tyrka, Błażej Skotnicki, Daniel Szymecki, Oliwia Jewuła, Szymon Pawlak, Piotr Przybyłowski, Tomasz Hrapkowicz

Abstract readObservational Study
In one paragraph

Observational study in Viruses, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Agnieszka KuczajDepartment of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.
Szymon WarwasDepartment of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.ORCID 0000-0001-9930-5864
Mikołaj TyrkaStudents' Scientific Association, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.
Błażej SkotnickiStudents' Scientific Association, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.
Daniel SzymeckiStudents' Scientific Association, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.
Oliwia JewułaStudents' Scientific Association, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.ORCID 0009-0004-4340-5902
Szymon PawlakDepartment of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.
Piotr PrzybyłowskiDepartment of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.
Tomasz HrapkowiczDepartment of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, M.C. Skłodowskiej 9, 41-800 Zabrze, Poland.ORCID 0000-0002-8945-7351

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeart failure (HF) remains a major global health challenge, with orthotopic heart transplantation (OHT) serving as the gold-standard therapy for end-stage disease. Chronic immunosuppression required to prevent graft rejection increases the risk of infections and malignancies. The COVID-19 pandemic underscored the particular vulnerability of transplant recipients to severe SARS-CoV-2 infection. Specific immunosuppressive agents used in OHT patients may differentially affect SARS-CoV-2 infection. In particular, mTOR inhibitors may modulate viral replication and immune responses, potentially influencing disease severity.

objectivesThis study evaluated the impact of immunosuppressive regimens-particularly mTOR inhibitors-on COVID-19 outcomes in heart transplant recipients, comparing mTOR-based therapy (with or without calcineurin inhibitors, CNIs) to non-mTOR-based regimens.

methodsThis single-center retrospective observational study included 556 orthotopic heart transplant recipients (76.3% male; median age, 58 years) followed from March 2020 to March 2024. To compare patients receiving mTOR inhibitors with similar non-mTOR recipients, 3:1 propensity score matching was performed based on age, sex, and body mass index. Among the study population, 88 patients (15.8%) received mTOR inhibitors (everolimus or sirolimus), of whom 66 were concomitantly treated with calcineurin inhibitors and 22 without. Data were obtained from the National Health Fund database and clinical follow-ups.

resultsOverall mortality was 13.5%, and COVID-19-related mortality 3.2%. COVID-19 incidence was 33% in the mTOR group versus 36.7% in the non-mTOR group (

conclusionsmTOR-based immunosuppression was non-inferior to standard therapy for COVID-19 outcomes. The absence of COVID-19-related deaths in patients on mTOR CNI-free regimens suggests potential protective effects that merit further investigation.

Indexed as

COVID-19Heart TransplantationImmunosuppressive AgentsMTOR InhibitorsTOR Serine-Threonine KinasesAdultAgedCalcineurin InhibitorsCOVID-19 Drug TreatmentEverolimusFemaleHumansMaleMiddle AgedRetrospective StudiesSARS-CoV-2Calcineurin InhibitorsEverolimusImmunosuppressive AgentsMTOR InhibitorsMTOR protein, humanTOR Serine-Threonine KinasesCOVID-19heart transplantationmTOR inhibitors

Identifiers

PMID41600794
PMCPMC12846580

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.