COVID-19 presenting with diarrhea in a heart transplant patient

Işık, Mehmet Emirhan; Günay, Deniz; Aksüt, Mehmet; Menekşe, Şirin; Uygun-Kızmaz, Yeşim; Kırali, Mehmet Kaan

doi:10.5606/tgkdc.dergisi.2021.20420

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Of the thirty-three studies, eleven were retrospective case series [ 7 , 11 , 14 , 19 , 20 , 26 , 29 – 33 , 38 , 39 ], while twenty-two were case reports [ 8 – 10 , 12 , 13 , 15 – 18 , 21 – 25 , 27 , 28 , 34 – 37 ]. All were peer-reviewed.…”

Section: Resultsmentioning

confidence: 99%

SARS-CoV-2 infection in heart transplant recipients: a systematic literature review of clinical outcomes and immunosuppression strategies

et al. 2021

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Section: Resultsmentioning

confidence: 99%

SARS-CoV-2 infection in heart transplant recipients: a systematic literature review of clinical outcomes and immunosuppression strategies

et al. 2021

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“…However, most cases of pancytopaenia in the presence of COVID-19 infection concern patients with an underlying haematological condition 22–24 and/or risk factors for cytopaenias such as chemotherapy, 25 26 methotrexate 27 and other immunosuppressant therapy. 28 The trajectory of COVID-induced pancytopaenia can range from being self-limiting 18 20–22 to worsening of blood parameters and clinical deterioration despite the use of blood products and optimal treatment of COVID-19 17 19 as seen in the case of our patient.…”

Section: Discussionmentioning

confidence: 75%

De novo pancytopaenia in an older adult with severe COVID-19 infection

2022

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During the COVID-19 pandemic, it was recognised that SARS-CoV-2 can cause multisystem illness. Non-respiratory complications observed early in the pandemic were haematological in nature. A rare but serious haematological complication of COVID-19 infection is pancytopaenia. We describe a case of an older adult without pre-existing haematological disease or risk factors for cell dyscrasia with severe pancytopaenia induced by COVID-19, who developed critical illness requiring respiratory support in intensive care and died. Our case report highlights that de novo pancytopaenia may only present with mild dermatological manifestations and may indicate severe COVID-19 infection. Management is primarily supportive and early involvement of haematology should be sought.

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“…COVID-19 illness can present with a wide range of clinical outcomes. Given their immunosuppressed status, OHT recipients faced COVID-19-related fatality rates of up to 25–30% prior to widespread vaccination efforts [ 4 , 5 , 7 , 8 ]. CAV may increase the risk of mortality from COVID-19 in OHT recipients, but whether COVID-19 can precipitate accelerated CAV remains unknown.…”

Section: Discussionmentioning

confidence: 99%

Accelerated Cardiac Allograft Vasculopathy in an Orthotopic Heart Transplant Recipient with Prior COVID-19

et al. 2023

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Patient: Male, 48-year-old Final Diagnosis: Cardiac amyloidosis Symptoms: Abdominal pain • dyspnea • palpitation Clinical Procedure: — Specialty: Cardiology Objective: Rare coexistence of disease or pathology Background: Cardiac allograft vasculopathy (CAV) is a post-orthotopic heart transplant (OHT) complication driven by intimal smooth muscle proliferation and immune hyperactivity to donor heart tissue. Accelerated CAV leads to allograft failure within 1 year after receiving a normal angiogram result. Viruses can contribute to CAV development, but CAV after SARS-CoV-2 infection has not been reported to date. Case Report: A 48-year-old man, 5 years after OHT for non-ischemic cardiomyopathy, was admitted to the Cardiac Care Unit with 3 days of abdominal pain, dyspnea, and palpitations. His medical history included hyperlipidemia and insulin-dependent diabetes. He was compliant with all medications. Two months prior, he had a mild COVID-19 case. An echocardiogram and coronary angiogram 6 and 9 months prior, respectively, were unremarkable. Right and left heart catheterization demonstrated increased filling pressures, a cardiac index of 1.7 L/ml/m 2 , and diffuse vasculopathy most severe in the LAD artery. Flow could not be restored despite repeated ballooning and intra-catheter adenosine. Empiric ionotropic support, daily high-dose methylprednisolone, and plasmapheresis were started. A few days later, the patient had cardiac arrest requiring venoarterial extracorporeal membranous oxygenation. Given CAV’s irreversibility, re-transplantation was considered, but the patient had an episode of large-volume hemoptysis and remained clinically unstable for transplant. The patient died while on palliative care. Conclusions: Our patient developed accelerated CAV 2 months after having COVID-19. While CAV has known associations with certain viruses, its incidence after SARS-CoV-2 infection is unknown. Further research is needed to determine if prior SARS-CoV-2 infection is a risk factor for development of CAV in OHT recipients.

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COVID-19 presenting with diarrhea in a heart transplant patient

Cited by 4 publications

References 7 publications

SARS-CoV-2 infection in heart transplant recipients: a systematic literature review of clinical outcomes and immunosuppression strategies

SARS-CoV-2 infection in heart transplant recipients: a systematic literature review of clinical outcomes and immunosuppression strategies

De novo pancytopaenia in an older adult with severe COVID-19 infection

Accelerated Cardiac Allograft Vasculopathy in an Orthotopic Heart Transplant Recipient with Prior COVID-19

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