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%. 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. 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.

中文翻译：

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儿科心脏移植受者中 COVID-19 的胃肠道表现


严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 相关的 2019 年冠状病毒病 (COVID-19) 最常引起轻度呼吸道疾病；然而，症状和疾病严重程度各不相同。它的死亡率约为7%。我们介绍了一名 9 岁女性患者，她在 7 天的心脏移植后出现左心发育不全综合征。她来到我们的急诊室，抱怨间歇性发烧、发冷、疲劳、食欲不振和腹泻。咽拭子核酸检测呈严重急性呼吸综合征冠状病毒2（SARS-CoV-2）阳性。静脉输液疗法用于纠正水合状态。据我们所知，这是首例报告的儿童心脏移植受者出现 2019 冠状病毒病 (COVID-19) 非肺部表现的病例，该病例经过保守治疗得到了成功。胃肠道表现可能是患有 COVID-19 的儿科心脏移植受者的唯一症状。保守治疗可以成功。用于心脏移植受者的免疫调节药物可能对 SARS-CoV-2 感染具有保护价值。