COVID-19 in lung transplant recipients: A multicenter study

Berta Saez-Giménez, Cristina Berastegui, Miriam Barrecheguren, Eva Revilla-López, Ibai Los Arcos, Rodrigo Alonso, Myriam Aguilar, Víctor M Mora, Isabel Otero, Juan P Reig, Carlos A Quezada, Virginia Pérez, Manuel Valle, Rosalía Laporta, María Deu, Judith Sacanell, Carles Bravo, Joan Gavalda, Manuel Lopez-Meseguer, Víctor Monforte, Berta Saez-Giménez, Cristina Berastegui, Miriam Barrecheguren, Eva Revilla-López, Ibai Los Arcos, Rodrigo Alonso, Myriam Aguilar, Víctor M Mora, Isabel Otero, Juan P Reig, Carlos A Quezada, Virginia Pérez, Manuel Valle, Rosalía Laporta, María Deu, Judith Sacanell, Carles Bravo, Joan Gavalda, Manuel Lopez-Meseguer, Víctor Monforte

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.

Keywords: clinical research / practice; critical care / intensive care management; drug toxicity; infection and infectious agents - viral; infectious disease; lung disease: infectious; lung transplantation / pulmonology.

© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.

Figures

FIGURE 1
FIGURE 1
Comparison of blood variables between discharged and deceased individuals [Color figure can be viewed at wileyonlinelibrary.com]

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Source: PubMed

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