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.