Treatment of Patients After Lung Transplantation With Covid Infection During Long-Term Follow-Up

Abstract

BackgroundPatients undergoing lung transplantation are routinely managed with lifelong immunosuppression associated with heightened risk for infections. This study delves into the therapeutic challenges and strategies employed in managing lung transplant recipients (LTRs) who were infected with COVID-19 during long-term follow-up. Patients and MethodsThe study is conducted as a case series analysis, among which non-standard therapies consisting of either targeted antibody treatment or antiviral drugs or anti-IL-6 drugs were applied in patients after lung transplantation. Additional analysis of laboratory test results for systemic inflammation and imaging studies was also carried out. The study was limited to a dedicated COVID-19 center, commonly known as a temporary hospital and included patients infected with Covid-19 in the late post-lung transplant period (home related infection). Results15 patients after LTx (lung transplantation) with current COVID-19 infection were treated with antibodies like tocilizumab, casirivimab and imdevimab and regdanvimab. 6,7 % (n=1) of the patients were given tocilizumab, 53,3% (n=8) casirivimab and imdevimab and 13,3 % (n=2) regdanvimab. Of the 15 LTRs studied, 53,3 % presented COVID-19 associated lung changes in CT scans. Common clinical manifestations included dyspnea, fever, and fatigue. Antiviral agents, like remdesivir, were employed in the remaining 26,7% (n:4) cases, and adjunctive therapies, such as corticosteroids and anticoagulants, were utilized selectively. All treated patients survived the infection without complications; the treatment proved to be effective and safe.