DISCUSSION
The rate of COVID-19 infection in cardiac transplant patients is double
compared to the general population. (7) According to an Italian study,
out of 47 post-heart transplant patients with COVID-19 infection, 37%
required hospitalization, and only 8.5% required intensive care
therapy. (7) Another single-centre, case-series form the US described
the characteristics, treatment, and outcomes of post-heart transplant
patients with COVID-19 infection; 28 patients required hospitalization,
majority of these patient presented with respiratory symptoms whereas
48% of these patients had gastrointestinal symptoms. The case fatality
rate in recipients of heart transplant who were infected with COVID-19
infection was around 25%. (6)
Latif et al described that majority of their patients had multiple
comorbidities, mainly hypertension, diabetes mellitus, obesity, and
chronic kidney disease. In the majority of their patients post COVID-19
infection were complicated by the cardiac injury (77%), 20% of their
patients required oxygen supplementation, and 7 patients required
intensive care therapy with supportive organ management. Seventy-seven
percent of patients required reduction in immunosuppression therapy,
along with antibiotics and COVID-19 therapy. None of their patients had
graft rejection.(6)
According to Biottio et al, 66% of their patients had a reduction in
immunosuppression therapy along with other COVID-19 therapy. (7)
Both above-mentioned studies (6, 7) described the mortality in
post-heart transplant patients with COVID-19 infection to be around 30%
and mainly due to respiratory and other multiple organ failure.
Our patient also had multiple comorbidities, presented with
gastrointestinal symptoms, had cardiac injury, and required support with
non-invasive ventilation. As in our patient, COVID-19 infection was
mild; it did not require any changes or reduction in their
immunosuppression therapy, and the patient was discharged home without
any complications.