ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
Heart transplant recipient survivor from COVID-19: The first case of Turkey
Güle Çınar1, Cahit Sarıcaoğlu2, Bahadır İnan2, İrem Dinçer3, Mehmet Çakıcı2, Tamer Sayın3, Alpay Azap1, Ahmet Rüçhan Akar2
1Department of Infectious Diseases and clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey
2Department of Cardiovascular Surgery, Ankara University School of Medicine, Ankara, Turkey
3Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2020.20291
Any highly infectious and rapidly spreading disease is a primary concern for immunocompromised solid organ transplant recipients. The number of data about the spectrum of clinical illness, the treatment modalities, and the outcomes of COVID-19 in this vulnerable population is scant and still remains empirical. Herein, we report the first COVID-19 case of a heart transplant recipient in Turkey who presented with fever, postnasal discharge, and myalgias for two days. The possibility of lung involvement was ruled out by thoracic computed tomography. Despite stable vital signs, we reduced the intensity of immunosuppressive therapy and maintained home self-isolation promptly. We also commenced a five-day course of hydroxychloroquine 200 mg q12h initially. After confirmation of real-time reverse-transcriptase-polymerasechain- reaction testing of the nasopharyngeal swab positive for COVID-19, the patient was hospitalized. After a loading dose of favipiravir 1,600 mg b.i.d., the patient received a five-day course of favipiravir 600 mg q12h. He was discharged with cure after 23 days of hospital isolation and treatment. In conclusion, treatment process can be affected by the daily electrocardiography, hand-held portable echocardiography, myocardial injury markers, and pulse oximeter for selfmonitoring in the follow-up of previous heart transplant recipients suffering from COVID-19. The lack of treatment protocols in the solid organ transplant recipients with COVID-19 infection and the controversies about the protective effect of immunosuppression invite a global and update discussion.
Keywords : COVID-19; heart transplantation; immunocompromised
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