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Updated: Jul 20, 2025

Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Case Report: The Challenge for Diagnosis of Myocarditis and Transplant Rejection After COVID Infection in a
Helio Milani Pegado1, Adailson Siqueira1, Joshua Navarajasegaran2
1Heart Institute (InCor), University of São Paulo Medical School (FMUSP), São Paulo, Brasil.
Abstract:
Patients who have undergone organ transplantation are immunosuppressed hosts, leaving them at a higher risk of infections. SARS-COV-2 has been shown to affect heart-transplanted patients. In this case report, we present the case of a 14-year-old heart transplant recipient who developed signs and symptoms of heart failure, along with fatigue, after a COVID-19 infection. An endomyocardial biopsy was performed to diagnose rejection and to evaluate whether this was myocarditis due to SARS-COV-2. The biopsy showed intense acute cellular rejection (3R) and antibody rejection PAMR1 H+ but was negative for the SARS-CoV-2 virus. The patient received organ rejection therapy with high-dose methylprednisolone and human immunoglobulin. After treatment, her heart function recovered, with biopsy investigations showing a lower level of cellular rejection (1R).
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