COVID19 and Heart Transplant: A Case Series and Review of the Literature

Ballout, Jad A.; Ahmed, Taha; Kolodziej, Andrew R.

COVID19 has resulted in many challenges in patient care especially high-risk populations such as heart transplant patients. Patients with heart transplant experience a significantly higher mortality rate with COVID19 infection, and management is based on extrapolation from clinical trials done on non-transplant patients, and from clinical experience. Here we report four cases of heart transplant patients who presented in late 2020 with COVID19 infection. Patients presented with symptoms similar to those seen in the general population. All four patients were admitted to the hospital, and they were all treated with dexamethasone. In addition, two patients received remdesivir. Immunosuppressive medications were adjusted to maintain adequate levels of immunosuppression, but at the same time allowing for an adequate immune response against the infection. All patients were discharged alive from the hospital. We then performed a literature review on studies that included heart transplant patients who developed the infection, and suggest a standardized management approach accordingly.