Abstract

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated coronavirus disease 2019 (COVID-19) most commonly causes a mild respiratory illness; however, there are wide ranges of presenting symptoms and disease severity. It has a mortality rate around 7%.Case presentationWe present a case of a 9-year-old female patient with hypoplastic left heart syndrome status post heart transplantation at age of 7 days. She presented to our emergency room complaining of intermittent fever, chills, fatigue, poor appetite, and diarrhea.A throat swab nucleic acid test was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Intravenous fluids therapy was used for correction of hydration status. To the best of our knowledge this is the first reported case of non-pulmonary presentation of coronavirus disease-2019 (COVID-19) in a pediatric heart transplant recipient, which was successfully managed conservatively.ConclusionsGastrointestinal manifestations can be the only presenting symptom in pediatric heart transplant recipients with COVID-19. Conservative treatment could be used successfully. Immunomodulatory medications that are used in heart transplant recipients may have protective value in SARS-CoV-2 infection.

Highlights

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated coronavirus disease 2019 (COVID-19) most commonly causes a mild respiratory illness; there are wide ranges of presenting symptoms and disease severity

  • Immunomodulatory medications that are used in heart transplant recipients may have protective value in SARS-CoV-2 infection

  • Serious and fatal cases of COVID-19 have been recorded in children; most pediatric groups tend to have asymptomatic, mild, or moderate presentations

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Summary

Conclusions

Gastrointestinal manifestations can be the only presenting symptom in pediatric heart transplant recipients with COVID-19. Immunomodulatory medications that are used in heart transplant recipients may have protective value in SARS-CoV-2 infection. More studies are needed to evaluate the difference in clinical course and outcome between pediatric and adult heart transplant recipients with COVID-19

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Competing interests None
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