“…While the risk for transplant recipients is well-documented due to the suppression of the immune system, the substantially higher risk of breakthrough infection for these patients compared to those with other known risk factors of COVID-19 (such as heart and cardiovascular diseases) was not previously known. 30 Our findings, that those with lung transplants are at highest risk for breakthrough infection amongst other solid organ transplant recipients are substantiated by the characteristics of COVID-19 as a respiratory disease and the important role of Antigen-Converting Enzyme 2 (ACE2) receptor in inducing viral entry in the lung epithelium, leading to infection and disease severity. 31 , 32…”