Publication date: Jun 27, 2025

To evaluate the effect of pharmaceutical care provided by clinical pharmacists during COVID-19 treated with nirmatrelvir/ritonavir in heart transplant (HT) patients. Three HT recipients were admitted to the hospital after testing positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) nucleic acid. Due to factors such as underlying immunosuppression resulting from the heart transplantation and the use of antirejection medications, patients who have undergone heart transplantation and become infected with SARS-CoV-2 exhibit significant differences in pathological responses and drug metabolism in the body compared to other patients. During the treatment period with nirmatrelvir/ritonavir, clinical pharmacists provided comprehensive pharmaceutical care for these patients throughout the course. After heart transplantation, testing positive for SARS-CoV-2 nucleic acid. During the treatment of the 3 patients with nirmatrelvir/ritonavir for COVID-19, clinical pharmacists provided pharmaceutical care from aspects such as medication indications, dosage administration, drug adjustments, drug interactions, and adverse reaction monitoring, in order to develop individualized medication regimens for the patients. Clinical pharmacists actively predicted, identified, and resolved issues that arose during the treatment of HT recipients with nirmatrelvir/ritonavir. They monitored the blood concentration of tacrolimus and the interactions between nirmatrelvir/ritonavir and other medications throughout the treatment process. All 3 patients were cured and discharged from the hospital. During the treatment process, managing complex polypharmacy posed significant challenges. Clinical pharmacists implemented individualized therapeutic drug monitoring to optimize antiviral efficacy. Through rational and effective pharmaceutical care, the clinical cure rate for HT recipients infected with COVID-19 was improved.

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