The impact of SARS-CoV-2 infection on heart transplant recipients is unknown. Literature is limited to case reports and series. The purpose of this study is to identify the clinical features, outcomes, and immunosuppression strategies of heart transplant recipients with COVID-19 infection. A systematic review was conducted using the search term "Coronavirus" or COVID," "SARS-CoV-2," "cardiac transplantation," and "heart transplant." Case reports and retrospective studies were gathered by searching Medline/PubMed, Google Scholar, CINAHL, Cochrane CENTRAL, and Web of Science. Thirty-three articles were selected for review. We identified 74 cases of SARS-CoV-2 infection in heart transplant and heart-kidney transplant recipients. The mean age was 60.5 ± 15.8 years, and 82.4% were males with median time from transplant of 6.5 years. Commonest symptoms were fever, cough, and dyspnea, but new left ventricular (LV) dysfunction was rare. Leukocytosis, lymphopenia, elevated inflammatory markers, and bilateral ground-glass opacities were common. Mortality was high, with particularly poor survival in patients who required intensive care unit (ICU) admission and older patients. Immunosuppression involved discontinuation of antimetabolites and steroids. COVID-19 infection in heart transplant (HT) recipients presents similarly to the general population, but new onset of LV dysfunction is uncommon. Immunosuppression strategies include increase in corticosteroids and discontinuation of antimetabolites.

中文翻译：

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心脏移植受者的 SARS-CoV-2 感染：临床结果和免疫抑制策略的系统文献综述。


SARS-CoV-2 感染对心脏移植受者的影响尚不清楚。文献仅限于病例报告和系列。本研究的目的是确定感染 COVID-19 的心脏移植受者的临床特征、结果和免疫抑制策略。使用搜索词“冠状病毒”或“COVID”、“SARS-CoV-2”、“心脏移植”和“心脏移植”进行系统评价。通过搜索 Medline/PubMed、Google Scholar 收集病例报告和回顾性研究、CINAHL、Cochrane CENTRAL 和 Web of Science 选择了 33 篇文章进行审查，其中 74 例心脏移植和心肾移植受者感染 SARS-CoV-2 病例，平均年龄为 60.5 ± 15.8 岁。 82.4% 是男性，移植后中位时间为 6.5 年，最常见的症状是发烧、咳嗽和呼吸困难，但新发的白细胞增多、淋巴细胞减少、炎症标志物升高和双侧毛玻璃样混浊很少见。死亡率很高，需要入住重症监护病房 (ICU) 的患者和需要停用抗代谢药物和类固醇的老年患者的生存率尤其低。心脏移植 (HT) 接受者的情况与普通人群相似。 ，但新发左心室功能障碍并不常见。免疫抑制策略包括增加皮质类固醇的用量和停用抗代谢药。