Background There is very limited experience in management of heart transplant (HT) recipients and their immunosuppressive drug therapies while confronted with a SARS-CoV-2 infection. Case details We report the case of a 60-year-old male, heart transplant recipient patient, admitted in our ICU for severe COVID-19. His immunosuppressors were discontinued. He presented an ARDS, a multiple organ failure and a refractory septic shock that eventually resulted in his death. Discussion Multiple studies reported a lower incidence of SARS-Cov-2 infection in HT recipients compared to the general population, probably due to their prior knowledge and use of protective and barrier measures; but when infected they tend to have poorer outcomes and higher fatality; on account of their pre-existing comorbidities and immunodeficiency. Therefore, the management of the immunosuppressive therapy raises a challenge, in the absence of trials. Physicians rely on experts’ recommendations, to maintain the immunosuppressors in case of mild COVID-19, lower to the bare minimum or even discontinue them in case of critical COVID-19 or systemic complications. Conclusion COVID-19 infection is associated with poor outcomes and high mortality in HT recipients, and their immunosuppressive therapy management still raises questions and challenges in the absence of trial-validated data. Highlights • Heart transplant recipients are believed to be at a higher COVID-19 infection risk. • ICU admission rate and the higher mortality risk is due to pre-existing comorbidities and immunodeficiency status of patients.
【저자키워드】 COVID-19, SARS-CoV-2, heart transplant, Immunosuppressors, 【초록키워드】 ARDS, therapy, severe COVID-19, knowledge, SARS-COV-2 infection, Infection, immunodeficiency, Comorbidity, risk, outcome, ICU, COVID-19 infection, heart, management, male, Patient, ICU admission, death, Septic shock, Mild, complications, General population, incidence, multiple organ failure, Critical, patients, trials, Protective, recommendations, mortality risk, immunosuppressive, recipients, high mortality, physician, recipient, Multiple, raise, reported, question, absence, maintain, 【제목키워드】 Immunosuppression, Case report, cardiac transplantation,