Abstract
Patients after lung transplantation are at risk for life-threatening infections. Recently, several publications on COVID-19 outcomes in this patient population appeared, but knowledge on optimal treatment, mortality, outcomes, and appropriate risk predictors is limited. A retrospective analysis was performed in a German high-volume lung transplant center between 19th March 2020 and 18th May 2021. Impact of COVID-19 on physical and psychological health, clinical outcomes, and mortality were analyzed including follow-up visits up to 12 weeks after infection in survivors. Predictive parameters on survival were assessed using univariate and multivariate proportional hazards regression models. Out of 1,046 patients in follow-up, 31 acquired COVID-19 during the pandemic. 12 of 31 (39%) died and 26 (84%) were hospitalized. In survivors a significant decline in exercise capacity (p = 0.034), TLC (p = 0.02), and DLCO (p = 0.007) was observed at follow-up after 3 months. Anxiety, depression, and self-assessed quality of life remained stable. Charlson comorbidity index predicted mortality (HR 1.5, 1.1-2.2; p = 0.023). In recipients with pre-existing CLAD, mortality and clinical outcomes were inferior. However, pre-existing CLAD did not predict mortality. COVID-19 remains a life-threatening disease for lung transplant recipients, particularly in case comorbidities. Further studies on long term outcomes and impact on pre-existing CLAD are needed.
Highlights
Since the beginning of the ongoing worldwide severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, more than 172 million confirmed cases and more than 3.7 million deaths were documented by the World Health Organization (WHO) in the report of June 9, 2021 [1].The clinical presentation of people infected by SARS-CoV-2 is termed as Coronavirus disease 2019 (COVID-19)
A total of 31 lung transplantation (LTx) recipients with confirmed infection by SARS-CoV-2 were included in this analysis (Fig 1)
Charlson Comorbidity Index (CCI) was 4 (4/ 5.5) indicating a substantial burden of comorbid conditions and n = 14 (45%) patients suffered from preexisting chronic lung allograft dysfunction (CLAD)
Summary
Since the beginning of the ongoing worldwide severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, more than 172 million confirmed cases and more than 3.7 million deaths were documented by the World Health Organization (WHO) in the report of June 9, 2021 [1]. The clinical presentation of people infected by SARS-CoV-2 is termed as Coronavirus disease 2019 (COVID-19). Contacts for data management requests: [Internet: “https://dzl.de/en/platforms/contact-centralbiobanking-management/”]. General public deposition of patient data is restricted according to the written informed consent which has been given from all patients for the use of their data for scientific purposes. Approval was given by the local institutional review board at Hannover Medical School Approval was given by the local institutional review board at Hannover Medical School (no. 2923-2015)
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