Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

New Conditions in Heart Transplantation in Persistence of SARS-CoV-2

Lubov Mitrofanova
,
Igor Makarov
ORCID logo ,
Andrey Gorshkov
,
Olga Vorobeva
,
Maria Simonenko
,
Anna Starshinova
* ,
Dmitry Kudlay
ORCID logo ,
Tatiana Karonova
Version 1 : Received: 12 June 2023 / Approved: 13 June 2023 / Online: 13 June 2023 (07:53:56 CEST)

A peer-reviewed article of this Preprint also exists.

Mitrofanova, L.; Makarov, I.; Gorshkov, A.; Vorobeva, O.; Simonenko, M.; Starshinova, A.; Kudlay, D.; Karonova, T. New Scenarios in Heart Transplantation and Persistency of SARS-CoV-2 (Case Report). Life 2023, 13, 1551. Mitrofanova, L.; Makarov, I.; Gorshkov, A.; Vorobeva, O.; Simonenko, M.; Starshinova, A.; Kudlay, D.; Karonova, T. New Scenarios in Heart Transplantation and Persistency of SARS-CoV-2 (Case Report). Life 2023, 13, 1551.

Abstract

Heart transplantation is a treatment of choice for patients with severe heart failure. Infection transmission from a donor to a recipient remains a prominent problem in organ transplantation. However, the risk of SARS-CoV-2 transmission through nonlung organ transplantation is still unclear. In the article we present a case of a 28-year-old pregnant woman who developed heart failure soon after recovery from SARS-CoV-2 infection in the third trimester of gestation. In the postpartum period the disease worsened and the patient required cardiac transplantation. We examined the recipient's heart and diagnosed left ventricular noncompaction cardiomyopathy. Immunohistochemical analysis showed the SARS-CoV-2 antigen expression in the donor’s heart before transplantation and after the surgery the endomyocardial biopsy was taken. Moreover, an ultrastructural assessment of the endomyocardial specimen revealed endothelial and pericyte injury and single particles on the surface of endothelium consistent with SARS-CoV-2. Recent findings were associated these damages with SARS-CoV-2 infection. The present study describes the rare case of SARS-CoV-2 transmission from donor to recipient through a heart transplant and resulting in endothelial cell and pericyte activation and humoral immune response activation.

Keywords

SARS-CoV-2 infection; immunohistochemical and ultrastructural myocardial studies; heart transplantation; virus transmission

Subject

Public Health and Healthcare, Other

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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