COVID-19 in Lung Transplant Recipients

Abstract

Background. A concern about the susceptibility of immunocompromised patients to the worldwide pandemic of coronavirus disease 2019 (COVID-19) has been raised. We aimed at describing COVID-19 infections in the French cohort of lung transplant (LT) patients. Methods. Multicenter nationwide cohort study of all LT recipients with COVID-19 diagnosed from March 1 to May 19, 2020. Recipient main characteristics and their management were retrieved. Hospitalization characteristics, occurrence of complications and survival were analyzed. Results. Thirty-five LT patients with a COVID-19 infection were included. Median age was 50.4 (40.6-62.9) years, 16 (45.7%) were female, and 80% were double-LT recipients. Infection was community-acquired in 25 (71.4%). Thirty-one (88.6%) required hospitalization, including 13 (41.9%) in the intensive care unit. The main symptoms of COVID-19 were fever, cough, and diarrhea, present in 71.4%, 54.3%, and 31.4% of cases, respectively. Extension of pneumonia on chest CT was moderate to severe in 51.4% of cases. Among the 13 critically ill patients, 7 (53.9%) received invasive mechanical ventilation. Thrombotic events occurred in 4 patients. Overall survival rate was 85.7% after a median follow-up of 50 days (41.0-56.5). Four of 5 nonsurvivors had had bronchial complications or intensification of immunosuppression in the previous weeks. On univariate analysis, overweight was significantly associated with risk of death (odds ratio, 16.0; 95% confidence interval, 1.5-170.6; P = 0.02). Conclusions. For the 35 LT recipients with COVID-19, the presentation was severe, requiring hospitalization in most cases, with a survival rate of 85.7%.

Clinical characteristics, management practices, and outcomes among lung transplant patients with COVID-19

“…The earlier series describing COVID-19 in LT patients from the United States [ 6 , 17 , 18 ] as well as from Spain [19] , Belgium [20] and France [21] reported markedly variable patient outcomes despite being from the same time period. The hospital outcomes in the largest case series from Spain were poor, with more than 80% of the patients developing respiratory failure and nearly 40% succumbing to the infection.…”

Immunogenicity of BNT162b2 mRNA COVID-19 vaccine and SARS-CoV-2 infection in lung transplant recipients

“…Lung Transplant Recipients (LTRs) are among the most vulnerable groups in the COVID-19 pandemic (mortality 14-39%). [1][2][3][4] An early report provided evidence of a poor antibody response after the first mRNA vaccine dose in solid organ transplant recipients. 5 However, the immunogenicity of the novel mRNA COVID-19 complete 2-dose vaccine in LTRs is unknown to date.…”

Coping strategies, anxiety and depression related to the COVID-19 pandemic in lung transplant candidates and recipients. Results from a monocenter series

“…The effect of the coronavirus disease 2019 (COVID-19) pandemic does not spare fragile patients, such as those with chronic respiratory insufficiency who are awaiting lung transplantation (LT) or LT recipients [1] . Studies of mental health during the first phase of the pandemic in the general population highlighted the occurrence of anxiety and depressive symptoms [2] .…”