COVID-19 pneumonia in a heart transplant recipient

    Authors

    Keywords

    chronic heart failure, heart transplantation, COVID-19

    DOI

    https://doi.org/10.15836/ccar2021.346

    Full Text

    Heart transplantation is a therapy of choice for patients with advanced terminal heart failure. A particular problem in these patients represents the titration of immunosuppressive therapy during infection, which is especially true in COVID-19. We present a case of a heart transplant recipient, who was successfully treated for a severe COVID-19 pneumonia. The patient underwent the orthotopic heart transplantation in 2018 at the age of 52 due to ischemic cardiomyopathy. Early posttransplantation phase was uneventful, and his immunosuppressive regimen consisted of tacrolimus and mycophenolate mofetil. Following the recommendations he was fully vaccinated for COVID-19. Despite this, one month after the last vaccine, he presented to our emergency department with dyspnea, prostration, fatigue and respiratory insufficiency. A bilateral pneumonia caused by SARS-CoV-2 was verified, and he was hospitalized in the COVID-19 primary intensive respiratory center where high flow oxygen therapy was immediately initiated. The treatment was further complicated by secondary pneumonias, extending the duration of his hospital stay. Finally, after two months of hospital treatment the patient was discharged home. The treatment of immunosuppressed heart transplant recipients for COVID-19 is an extraordinary clinical challenge, requiring an uneasy act of balance between a deadly infection and a potentially equally fatal heart transplant rejection. ( 1 )

    Cardiologia Croatica
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    COVID-19 pneumonia in a heart transplant recipient

    Extended Abstract
    Issue11-12
    Published
    Pages345
    PDF via DOIhttps://doi.org/10.15836/ccar2021.346
    chronic heart failure
    heart transplantation
    COVID-19

    Authors

    Ružica Lovrić*ORCIDKlinička bolnica Dubrava, Zagreb, Hrvatska
    Dora AldžićORCIDKlinička bolnica Dubrava, Zagreb, Hrvatska
    Mario UdovičićORCIDKlinička bolnica Dubrava, Zagreb, Hrvatska
    Goranka OremovićKlinička bolnica Dubrava, Zagreb, Hrvatska
    Ivica BenkoORCIDKlinička bolnica Dubrava, Zagreb, Hrvatska

    Full Text

    Heart transplantation is a therapy of choice for patients with advanced terminal heart failure. A particular problem in these patients represents the titration of immunosuppressive therapy during infection, which is especially true in COVID-19. We present a case of a heart transplant recipient, who was successfully treated for a severe COVID-19 pneumonia. The patient underwent the orthotopic heart transplantation in 2018 at the age of 52 due to ischemic cardiomyopathy. Early posttransplantation phase was uneventful, and his immunosuppressive regimen consisted of tacrolimus and mycophenolate mofetil. Following the recommendations he was fully vaccinated for COVID-19. Despite this, one month after the last vaccine, he presented to our emergency department with dyspnea, prostration, fatigue and respiratory insufficiency. A bilateral pneumonia caused by SARS-CoV-2 was verified, and he was hospitalized in the COVID-19 primary intensive respiratory center where high flow oxygen therapy was immediately initiated. The treatment was further complicated by secondary pneumonias, extending the duration of his hospital stay. Finally, after two months of hospital treatment the patient was discharged home. The treatment of immunosuppressed heart transplant recipients for COVID-19 is an extraordinary clinical challenge, requiring an uneasy act of balance between a deadly infection and a potentially equally fatal heart transplant rejection. ( 1 )