Naslov
COVID-19 in heart transplant recipients

Autori
Mjehović, Petra ; Čikeš, Maja ; Dubravčić, Mia ; Fabijanović, Dora ; Jakuš, Nina ; Jurin, Hrvoje ; Lovrić, Daniel ; Ljubas Maček, Jana ; Pašalić, Marijan ; Planinc, Ivo ; Samardžić, Jure ; Skorić, Boško ; Miličić, Davor

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Cardiologia Croatica, 16 (2021), 1-2 / - , 2021, 25-26

Skup
13. kongres Hrvatskoga kardiološkog društva s međunarodnim sudjelovanjem

Mjesto i datum
Online, 10.12.2020. - 24.01.2021

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
heart transplantation ; COVID-19 ; immunosuppression therapy

Sažetak
Introduction: Data on heart transplant (HTx) patients and infection with acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are very limited. There is significant heterogeneity in the clinical presentation. 1 Immunosuppression-related issues are of the main concern because of an increased risk for viral replication and superimposed infections. There is no evidence-based recommendation for the management of these patients. Some authors suggest modification in immunosuppression, i.e. discontinuation of mycophenolate mofetil (MMF) and calcineurin inhibitor (CNI) reduction in patients with more severe clinical presentation.2 Patients and Methods: This is a case series of 5 HTx recipients from our center who tested positive for COVID-19 infection and were treated in different COVID-19 specialized units. Results: There were 4 male and one female patients, 62-75 years old. Four of them were symptomatic and hospitalized, while one remained self-quarantined at home. The clinical presentation was mild to moderate, with symptoms including mild fever, dyspnea, and myalgia. X-ray signs of pneumonia were present in 3 patients, but none needed ICU care nor mechanical ventilation. Both a reduction of CNI dose with lower target serum concentration and MMF was discontinued in all patients. One patient was treated with hydroxychloroquine, one with remdesivir and one with steroid therapy. Antibiotics prophylaxis was administered in 2 patients. None of the patients experienced overt graft rejection and all patients have successfully recovered (Table 1). Conclusion: Lacking any evidence-based recommendation for the treatment of HTx patients infected with SARS-CoV-2, we are challenged to modify maintenance immunosuppression carefully balancing between the risk of uncontrolled viral replication with a superimposed infection on one side, and the increased risk of graft rejection on the other side. Further studies are needed to determine the optimal management of COVID-19 infection in these patients.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA