Early COVID-19 infection after lung transplantation in a patient with cystic fibrosis

Athanazio, Rodrigo Abensur; Costa, André Nathan; Carraro, Rafael Medeiros; González, D.; Rached, Samia Zahi; Samano, Marcos Naoyuki; Teixeira, Ricardo Henrique de Oliveira Braga; Campos, Sílvia Vidal

doi:10.6061/clinics/2020/e2274

Cited by 5 publications

(31 citation statements)

References 6 publications

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“…1 . Most included studies were case reports (n=89) [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] ...…”

Section: Resultsunclassified

SARS-CoV-2 in Solid Organ Transplant Recipients: A Structured Review of 2020

Quante

Brake

Tolios

et al. 2021

Transplantation Proceedings

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Background : The SARS-CoV-2 pandemic is challenging health systems all over the world. Particularly high-risk groups show considerable mortality rates after infection. In 2020, an inexorable number of case reports, case series and ultimately various systematic reviews have been published reporting on morbidity and mortality risk of SARS-CoV-2 in solid organ transplant (SOT) recipients. However, this vast array of publications resulted in an increasing complexity of the field, overwhelming even the expert reader. Methods : We performed a structured literature review comprising electronic databases, transplant journals and included literature from previous systematic reviews covering the entire year 2020. From 164 included articles we identified 3451 cases of SARS-CoV-2 infected SOT recipients. Results : Infections resulted in a hospitalization rate of 84% and 24% intensive care unit admissions (ICU) in the included patients. Whereas 53.6% of patients were reported to have recovered, cross-sectional overall mortality reported after COVID-19 was at 21.1%. Synoptic data concerning immunosuppressive medication attested to the reduction or withdrawal of antimetabolites (81.9%) and calcineurin inhibitors (48.9%) as a frequent adjustment. In contrast, steroids were reported to be increased in 46.8% of SOT patients. Conclusions : COVID-19 in SOT recipients is associated with high morbidity and mortality worldwide. Conforming with current guidelines, modifications of immunosuppressive therapies mostly comprised a reduction or withdrawal of antimetabolites and calcineurin inhibitors, while frequently maintaining or even increasing steroids. Here, we provide an accessible overview to the topic and synoptic estimates of expectable outcomes regarding in-hospital mortality of SOT patients diseased with COVID-19.

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Section: Resultsunclassified

SARS-CoV-2 in Solid Organ Transplant Recipients: A Structured Review of 2020

Quante

Brake

Tolios

et al. 2021

Transplantation Proceedings

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“…Regarding patients with CF and COVID-19, the sex proportion was (female/male) 1207/1167 [24,25,[27][28][29][30][31][32][33][34][35][36][37][38][39][41][42][43]45,[47][48][49][50]. Some publications [21,26,35,40,46] did not report the sex of the patients.…”

Section: Systematic Review Of Covid-19 Among Those With Cf-worldwide ...mentioning

confidence: 99%

“…A total of 31 papers published as observational studies reported an association of COVID-19 in patients with CF [18][19][20][21] (Table 1). These studies comprised 661,386 patients in total, including children, adults, and elderly age groups.…”

Section: Systematic Review Of Covid-19 Among Those With Cf-worldwide ...mentioning

confidence: 99%

“…The child displayed breathing difficulties and need for non-invasive ventilation management and high-flow therapy in the intensive care unit. A ventilatory test showed: a peak pressure of 21 In the period evaluated, 31 patients tested positive for COVID-19, 15 were male with a mean age range of 31 years, and 12 were lung transplant recipients. Most of the patients had CF-related diabetes (n = 19, 61.3%), and a mild lung disease (n = 19, 65.0%), with percent-predicted forced expiratory volume in one second <70%.…”

Section: Case Report One Patientmentioning

confidence: 99%

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Epidemiological Profile of Hospitalized Patients with Cystic Fibrosis in Brazil Due to Severe Acute Respiratory Infection during the COVID-19 Pandemic and a Systematic Review of Worldwide COVID-19 in Those with Cystic Fibrosis

Marques,

Boschiero,

Sansone

et al. 2023

Healthcare

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Since the onset of the coronavirus disease, COVID-19 pandemic, concern arose for those who might be at higher risk of a worse COVID-19 prognosis, such as those with cystic fibrosis (CF). In this context, we evaluated the features of hospitalized patients with CF due to severe acute respiratory infection (SARI) in Brazil and we also performed a systematic review including all the studies published from the beginning of the first case of COVID-19 (17 November 2019) to the date of this search (23 May 2022) which included, concomitantly, patients with CF and COVID-19 in the worldwide population. In our Brazilian data, we evaluated the period from December 2019 to March 2022, and we included 33 demographical and clinical patients’ features. We classified the patients into groups: (G1) SARI due to another viral infection than severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (23; 5.4%), (G2) SARI due to an unknown etiological agent (286; 67.1%), and (G3) SARI due to SARS-CoV-2 infection (117; 27.5%). The individuals in G3 tended to be older, especially over 50 years old, and presented a higher prevalence of dyspnea, peripheral capillary oxygen saturation (SpO2) <95%, and cardiopathy. The highest prevalence for intensive care unit (ICU) treatment (52; 44.4%) and invasive mechanical ventilation (29; 24.8%) was for patients in G3. Almost half of the patients in G3 died (51; 43.6%); in contrast, none in G1 died. However, we observed 43 (15.0%) deaths in G2. In addition, 12 (4.2%) and one (0.9%) death not associated with SARI occurred, respectively, in the G2 and G3. The patients who died due to SARS-CoV-2 infection had a higher frequency of SpO2 <95% (46; 90.2%), ICU treatment (34; 66.7%), and invasive mechanical ventilation (27; 52.9%) when compared to those who recovered. The systematic review comprised a total of 31 papers published as observational studies. These studies comprised 661,386 patients in total, including children, adults, and elderly age groups. However, only 19,150 (2.9%) patients were diagnosed with CF and, from these patients, 2523 (0.4%) were diagnosed with both CF and COVID-19. It was observed that the most common outcome was the need for hospitalization (n = 322 patients with CF), and the need for oxygen support (n = 139 patients with CF). One hundred patients with CF needed intensive care units, fifty patients needed non-invasive mechanical ventilation support, and only three patients were described as receiving invasive mechanical ventilation support. Deaths were described in 38 patients with CF. Importantly, lung-transplanted patients with CF represented an increased risk of death in one publication; in accordance, another study described that lung transplantation and moderate to severe lung disease were independent risk factors for severe outcomes after SARS-CoV-2 infection. In contrast with the literature, in conclusion, Brazilian patients in G3 presented a severe phenotype, even though most of the other studies did not observe worse outcomes in patients with CF and COVID-19.

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“…(5) Vários relatos e séries de casos confirmaram a associação de transplante pulmonar em pacientes com FC e formas graves de COVID-19. (6)(7)(8) Esses dados reforçam que a imunossupressão relacionada ao transplante seria um fator contribuinte para um maior risco de complicações do que a própria FC. Entretanto, estamos longe de assumir que não há riscos relacionados à COVID-19 para pacientes com FC.…”

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Early COVID-19 infection after lung transplantation in a patient with cystic fibrosis

Cited by 5 publications

References 6 publications

SARS-CoV-2 in Solid Organ Transplant Recipients: A Structured Review of 2020

SARS-CoV-2 in Solid Organ Transplant Recipients: A Structured Review of 2020

Epidemiological Profile of Hospitalized Patients with Cystic Fibrosis in Brazil Due to Severe Acute Respiratory Infection during the COVID-19 Pandemic and a Systematic Review of Worldwide COVID-19 in Those with Cystic Fibrosis

Is cystic fibrosis a risk factor for COVID-19 infection or related complications?

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