CONCLUSION
To date, few anecdotal results have been reported in the literature regarding infection with SARS-CoV-2 in heart transplant recipients. Our strategy primarily consisted of lowering the dose of their immunosuppressive therapy facing the viral infection and introducing corticosteroids to reduce the hyperinflammatory state and the risk of graft failure. Despite the limited number of affected patients, this report suggests that special considerations should be given to COVID-19 in the heart transplant population. Given the information available in the literature, the case fatality rate for this vulnerable cohort is doubled that of the overall population and the best therapeutic strategy remains unclear. Prompt referral to a transplant centre following onset of first symptoms is required in order to treat the disease immediately and avoid progression to severe forms.
Conflict of interest: none declared.

Author contributions
Raphael Caraffa: Writing—original draft. Lorenzo Bagozzi: Data curation. Alessandro Fiocco: Writing—original draft. Olimpia Bifulco: Formal analysis. Matteo Nadali: Methodology. Matteo Ponzoni: Data curation. Massimiliano Carrozzini: Supervision. Giuseppe Toscano: Validation. Angela Pompea Fraiese: Validation. Marco Metra: Writing—review & editing. Carlo Maria Lombardi: Writing—review & editing. Francesco Serafini: Data curation. Angela Ribola: Data curation. Vjola Jorgji: Writing—review & editing. Tomaso Bottio: Conceptualization; Writing—review & editing. Gino Gerosa: Conceptualization.

Reviewer information
European Journal of Cardio-Thoracic Surgery thanks Sai Bhagra and the other, anonymous reviewer(s) for their contribution to the peer review process of this article.  Abbreviations
COVID-19 Coronavirus disease 2019
IQR Interquartile range
SARS-CoV-2 Severe acute respiratory syndrome coronavirus-2