COVID-19 in lung transplant patients: A case series

Verleden, Geert M.; Godinas, Laurent; Lorent, Natalie; Bleyenbergh, Pascal Van; Dupont, Lieven; Delcroix, Marion; Yserbyt, Jonas; Dooms, Christophe; Vos, Robin

doi:10.1111/ajt.16212

Cited by 38 publications

(43 citation statements)

References 17 publications

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“…Although early considerations judged transplant recipients to be more prone to severe courses of COVID‐19 due to their chronically immune‐incompetent state, there are also considerations that immunosuppression might be protective against fatal disease 23 . The inflammatory response to SARS‐CoV‐2 might be attenuated in transplant recipients 8,24 and their risk for mortality due to COVID‐19 does not seem to be excessively increased 15,25,26 . This was supported by the results of our present study, with a majority of survey participants reporting favorable courses in LTx recipients.…”

Section: Discussionsupporting

confidence: 81%

“…The COVID‐19 pandemic rapidly spread worldwide in early 2020 and the first cases of COVID‐19 in LTx recipients have already been reported from centers all over the world 7–15 . Due to their generally increased vulnerability to viral infections, immunocompromised patients were considered to be at high risk for critical courses of COVID‐19.…”

Section: Discussionmentioning

confidence: 99%

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Management of lung transplantation in the COVID-19 era—An international survey

Coiffard

Lepper

Prud’Homme

et al. 2021

American Journal of Transplantation

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It is unknown if solid organ transplant recipients are at higher risk for severe COVID‐19. The management of a lung transplantation (LTx) program and the therapeutic strategies to adapt the immunosuppressive regimen and antiviral measures is a major issue in the COVID‐19 era, but little is known about worldwide practice. We sent out to 180 LTx centers worldwide in June 2020 a survey with 63 questions, both regarding the management of a LTx program in the COVID‐19 era and the therapeutic strategies to treat COVID‐19 LTx recipients. We received a total of 78 responses from 15 countries. Among participants, 81% declared a reduction of the activity and 47% restricted LTx for urgent cases only. Sixteen centers observed deaths on waiting listed patients and eight centers performed LTx for COVID‐19 disease. In 62% of the centers, COVID‐19 was diagnosed in LTx recipients, most of them not severe cases. The most common immunosuppressive management included a decreased dose or pausing of the cell cycle inhibitors. Remdesivir, hydroxychloroquine, and azithromycin were the most proposed antiviral strategies. Most of the centers have been affected by the COVID‐19 pandemic and proposed an active therapeutic strategy to treat LTx recipients with COVID‐19.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Management of lung transplantation in the COVID-19 era—An international survey

Coiffard

Lepper

Prud’Homme

et al. 2021

American Journal of Transplantation

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“…To be included, the study must have reported clinical data on adult (A-CA) or pediatric (P-CA) cancer patients and SOT or HCT recipients with confirmed COVID-19. Our inclusion and exclusion criteria identified 64 SOT studies, 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 11 HCT studies,…”

Section: Methodsmentioning

confidence: 99%

COVID-19 in immunocompromised patients: A systematic review of cancer, hematopoietic cell and solid organ transplant patients

Belsky¹,

Tullius²,

Lamb³

et al. 2021

Journal of Infection

194

166

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Background: The clinical impact of severe coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in immunocompromised patients has not been systematically evaluated. Methods: We reviewed current literature reporting on COVID-19 in cancer (CA), hematopoietic cell (HCT), and solid organ transplant (SOT) patients and compared their clinical data and outcomes to the general population. For adult CA, HCT and SOT patients, an extensive search strategy retrieved all articles published until July 20, 2020 by combining the terms coronavirus, coronavirus infection, COVID-19 , and SARS-CoV-2 in PubMed, Cochrane, and Web of Science, and following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. For the pediatric CA cohort, a global COVID-19 registry was used. For the general population cohort, a large meta-analysis was used to compare pooled prevalence estimates, and two large meta-analyses were utilized to serve as pooled comparators for hospitalized COVID-19 patients. Findings: Compared to the general population, adult CA and SOT patients with COVID-19 had higher comorbidities, greater levels of inflammatory markers at diagnosis, and higher rates of intensive care and hospital mortality. Pediatric CA patients and HCT patients with COVID-19 tended to have clinical presentations and outcomes similar to the general population. Interpretation: To our knowledge, this is the first systematic review evaluating COVID-19 phenotype and outcomes in immunocompromised patients and comparing them to the general population, which shows that hospital outcomes appear to be worse in adult CA and SOT patients, potentially due to their higher co-morbidity burden.

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“…Mortality ranged from 9 to 46% with most in the 18–30% range depending on the cohort and circumstances 14,15,17,33,72,73,75,77‐79,83‐85,88,89,91,94,95,103,104 . All‐cause mortality during the study period of the UK registry reached 26% for SOT recipients and 10% for those on the waitlist, although local utilization decisions related to resource availability may have impacted these numbers 74 .…”

Section: Epidemiology and Outcomesmentioning

confidence: 99%

Impact of COVID-19 in solid organ transplant recipients

Danziger‐Isakov

Blumberg

Manuel

et al. 2021

American Journal of Transplantation

120

109

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The coronavirus disease 2019 (COVID‐19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) exploded onto the world stage in early 2020. The impact on solid organ transplantation (SOT) has been profound affecting potential donors, candidates, and recipients. Importantly, decreased donations and the pressure of limited resources placed on health care by the pandemic also disrupted transplant systems. We address the impact of COVID‐19 on organ transplantation globally and review current understanding of the epidemiology, outcomes, diagnosis, and treatment of COVID‐19 in SOT recipients.

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COVID-19 in lung transplant patients: A case series

Cited by 38 publications

References 17 publications

Management of lung transplantation in the COVID-19 era—An international survey

Management of lung transplantation in the COVID-19 era—An international survey

COVID-19 in immunocompromised patients: A systematic review of cancer, hematopoietic cell and solid organ transplant patients

Impact of COVID-19 in solid organ transplant recipients

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