COVID-19 in lung transplant recipients: A single center case series from New York City

Meghan Aversa, Luke Benvenuto, Michaela Anderson, Lori Shah, Hilary Robbins, Marcus Pereira, Jenna Scheffert, Maggie Carroll, Jamie Hum, Margaret Nolan, Genevieve Reilly, Philippe Lemaitre, Bryan P Stanifer, Frank D'Ovidio, Joshua Sonett, Selim Arcasoy, From the Columbia University Lung Transplant Program, Meghan Aversa, Luke Benvenuto, Michaela Anderson, Lori Shah, Hilary Robbins, Marcus Pereira, Jenna Scheffert, Maggie Carroll, Jamie Hum, Margaret Nolan, Genevieve Reilly, Philippe Lemaitre, Bryan P Stanifer, Frank D'Ovidio, Joshua Sonett, Selim Arcasoy, From the Columbia University Lung Transplant Program

Abstract

There are limited data describing COVID-19 in lung transplant recipients. We performed a single center, retrospective case series study of lung transplant patients followed by the Columbia Lung Transplant program who tested positive for SARS-CoV-2 between March 19 and May 19, 2020. Thirty-two lung transplant patients developed mild (16%), moderate (44%), or severe (41%) COVID-19. The median age of patients was 65 years, and the median time from lung transplant was 5.6 years. Symptoms included cough (66%), dyspnea (50%), fever (47%), and gastrointestinal upset (44%). Patients received hydroxychloroquine (84%), azithromycin (75%), augmented steroids (44%), tocilizumab (19%), and remdesivir (9%). Eleven patients (34%) died at a median time of 14 days from admission. Complications during admission included: acute kidney injury (63%), transaminitis (31%), shock (31%), acute respiratory distress syndrome (25%), neurological events (25%), arrhythmias (22%), and venous thromboembolism (9%). Compared to patients with moderate COVID-19, patients with severe COVID-19 had higher peak white blood cell counts (15.8 vs 7 × 103 /uL, P = .019), C-reactive protein (198 vs. 107 mg/L, P = .010) and D-dimer (8.6 vs. 2.1 ug/mL, P = .004) levels, and lower nadir lymphocyte counts (0.09 vs. 0.4 × 103 /uL, P = .006). COVID-19 is associated with severe illness and a high mortality rate in lung transplant recipients.

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

Figures

FIGURE 1
FIGURE 1
Trends of IL-6, ferritin, and CRP levels of patients with moderate and severe COVID-19 during admission [Colour figure can be viewed at wileyonlinelibrary.com]

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Source: PubMed

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