• Shuroug A Alowais, Mohammed Bosaeed, Khalid Bin Saleh, Hajar AlQahtani, Nedim Selimovic, Husnat Ahmed, Abdullah A Alghamdi, Arif Hussain, and Hisham A Badreldin.
• College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, City, Saudi Arabia.
• Medicine (Baltimore). 2023 Oct 27; 102 (43): e35464e35464.

RationaleManagement of coronavirus disease 2019 (COVID-19) has been the subject of extensive research and study, leading to the development of strategies and treatments. Nonetheless, there remains a dearth of information concerning patients who require mechanical circulatory system support. This case report presents one of the first documented cases of successful utilization of nirmatrelvir/ritonavir (Paxlovid) and dexamethasone in the treatment of a patient with a total artificial heart.Patient ConcernsThe patient in this case study was a 28-year-old male who had been experiencing severe heart failure. In need of a heart transplant, he underwent a procedure for implantation of a total artificial heart as a bridge to transplantation.DiagnosesUnfortunately, after the surgical intervention, the patient contracted COVID-19, as confirmed by polymerase chain reaction.InterventionsThe therapeutic approach involved a 5-day regimen of nirmatrelvir/ritonavir at a dosage of 300/100 mg administered twice daily, along with a daily dosage of 6 mg of dexamethasone.OutcomesRemarkably, the patient oxygenation level improved on the second day of therapy. Consequently, he was transferred from the intensive care unit to the general floor. After 71 days with the total artificial heart, the patient successfully underwent heart transplantation.LessonsThis case report provides a compelling example of the successful application of nirmatrelvir/ritonavir and dexamethasone in the treatment of a COVID-19 patient with a total artificial heart. The positive outcome observed in this case underscores the potential use of these therapeutic agents in this specific patient population. However, it is imperative to conduct further research to corroborate and validate these initial findings. This study lays the foundation for further exploration of the efficacy of these drugs in patients with mechanical circulatory support systems.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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