Gill Heart Institute, University of Kentucky, Lexington, Kentucky.
Department of Internal Medicine, University of Kentucky, Lexington, Kentucky.
Transplant Proc. 2021 May;53(4):1219-1223. doi: 10.1016/j.transproceed.2021.02.015. Epub 2021 Feb 25.
Coronavirus disease 2019 (COVID-19) has resulted in many challenges in patient care, especially among high-risk populations such as heart transplant recipients. Patients with heart transplant experience a significantly higher mortality rate with COVID-19 infection, and management is based on extrapolation from clinical trials done on nontransplant patients and from clinical experience. Here we report 4 cases of patients with heart transplant who presented with COVID-19 infection in late 2020. Patients presented with symptoms similar to those seen in the general population. All 4 patients were admitted to the hospital, and they were all treated with dexamethasone. In addition, 2 patients received remdesivir. Immunosuppressive medications were adjusted to maintain adequate levels of immunosuppression but at the same time allow 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 developed suggestions for a standardized management approach, which we share in this article.
2019 年冠状病毒病（COVID-19）给患者治疗带来了许多挑战，特别是在心脏移植受者等高危人群中。COVID-19 感染使心脏移植患者的死亡率显著升高，其管理是基于对非移植患者进行的临床试验和临床经验的推断。在这里，我们报告了 4 例 2020 年末出现 COVID-19 感染的心脏移植患者。这些患者表现出与普通人群相似的症状。所有 4 例患者均住院治疗，均接受地塞米松治疗。此外，2 例患者接受了瑞德西韦治疗。调整免疫抑制药物以维持足够的免疫抑制水平，但同时允许对感染产生足够的免疫反应。所有患者均从医院出院，且存活。随后，我们对包括发生感染的心脏移植患者的研究进行了文献回顾，并制定了标准化管理方法的建议，本文对此进行了分享。
