Gastrointestinal presentation of COVID-19 in a pediatric heart transplant recipient

• Main Authors: Abdelmonem Helal, Ahmed F. Elmahrouk, Ahmed A. Jamjoom, Jameel A. Al-Ata
• Format: Article
• Language: English
• Published: SpringerOpen 2020-11-01
• Series: The Cardiothoracic Surgeon
• Subjects: SARS-CoV-2; Pediatric heart transplant recipient; Gastrointestinal presentation
• Online Access: http://link.springer.com/article/10.1186/s43057-020-00034-z

Abstract Background Severe 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 presentation We 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. Conclusions Gastrointestinal 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.