COVID-19 in Lung Transplant Recipients: A Multicenter Study

Overview

Journal Am J Transplant

Publisher Elsevier

Specialty General Surgery

Date 2020 Oct 22

PMID 33089648

Citations 38

Authors

Berta Saez-Gimenez

Cristina Berastegui

Miriam Barrecheguren

Eva Revilla-Lopez

Ibai Los Arcos

Rodrigo Alonso

Myriam Aguilar

Victor M Mora

Isabel Otero

Juan P Reig

Carlos A Quezada

Virginia Perez

Manuel Valle

Rosalia Laporta

Maria Deu

Judith Sacanell

Carles Bravo

Joan Gavalda

Manuel Lopez-Meseguer

Victor Monforte

Affiliations

Soon will be listed here.

Abstract

This study describes the clinical presentation, treatment, and outcomes of SARS-CoV-2 infection in lung transplant recipients (LTRs). This is a multicenter, retrospective study of all adult LTRs with confirmed SARS-CoV-2 infection from March 4 until April 28, 2020 in six Spanish reference hospitals for lung transplantation. Clinical and radiological data, treatment characteristics, and outcomes were reviewed. Forty-four cases were identified in that period. The median time from transplantation was 4.2 (interquartile range: 1.11-7.3) years. Chest radiography showed acute parenchymal abnormalities in 32 (73%) cases. Hydroxychloroquine was prescribed in 41 (93%), lopinavir/ritonavir (LPV/r) in 14 (32%), and tocilizumab in 19 (43%) patients. There was a strong interaction between tacrolimus and LPV/r in all cases. Thirty-seven (84%) patients required some degree of respiratory support and/or oxygen therapy, and 13 (30%) were admitted to intermediate or intensive critical care units. Seventeen (39%) patients had died and 20 (45%) had been discharged at the time of the last follow-up. Deceased patients had a worse respiratory status and chest X-ray on admission and presented with higher D-dimer, interleukin-6, and lactate dehydrogenase levels. In this multicenter LTR cohort, SARS-CoV-2 presented with high mortality. Additionally, the severity of disease on presentation predicted subsequent mortality.

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