COVID‐19 in lung transplant recipients: A single‐center experience

Abstract

Background Coronavirus disease 2019 (COVID‐19) is a global health problem. However, the course of this disease in immunosuppressed patients remains unknown. This study aimed to describe the course of COVID‐19 infection and its effects on lung transplant recipients. Methods This was a single‐center, retrospective, observational study. The recipients with suspicious symptoms and/or a contact history with infected individuals were diagnosed with COVID‐19 by performing a reverse transcription‐polymerase chain reaction (RT‐PCR) test using samples obtained from the nasopharynx swabs or bronchial lavage. We classified the patients into mild, moderate, and high severity groups according to their clinical conditions. In patients with positive RT‐PCR results, cell cycle inhibitor drugs were withdrawn, while steroids were maintained at the same level as in patients without clinical deterioration. Results Of the seven recipients diagnosed with COVID‐19 infection, one experienced a re‐infection. Each recipient had at least one comorbidity. Smell disorder (12.5%), cough/dyspnea (37%), and fever/chills/shivering (37%) were the most frequent symptoms. The mean follow‐up time after infection was 108 days. No deaths were recorded due to COVID‐19; however, the pulmonary function test values of two recipients were decreased during subsequent follow‐ups. Conclusion In our small group of transplant recipients with COVID‐19, there were two cases of pulmonary function deterioration and a case of re‐infection, and no recipient died. It is suggested that steroid therapy should be initiated in the early period in patients with pulmonary opacities.

Clinical Characteristics of Bloodstream Infection in Immunosuppressed Patients: A 5-Year Retrospective Cohort Study

“…Patients meeting any of the following criteria for immunosuppression were selected: (1) tumor (organ and blood system); (2) solid-organ, stem cell, or bone marrow transplantation states; (3) autoimmune diseases with immunosuppressive therapy (more than 10 mg of prednisone or equivalent per day for at least 3 weeks or oral methotrexate, cyclosporine, azathioprine, or biological modifiers within 3 months); (4) poor diabetes control; (5) liver cirrhosis; (6) postoperative critical condition; and (7) burns ( McCann et al., 2004 ; Blanchard et al., 2020 ; Lindell et al., 2020 ; Mada et al., 2020 ; Barlas et al., 2021 ; Turkkan et al., 2021 ).…”

“…IS patients with infections may present with atypical signs and symptoms. Consequently, there is possibly a delay in diagnosis and treatment resulting in a poor prognosis of IS patients ( Turkkan et al., 2021 ). IS status is closely related to mortality, and IS is associated with diverse pathogens including infection with bacteria, fungi, and viruses ( McCann et al., 2004 ; Lindell et al., 2020 ; Li et al., 2021 ).…”

Reinfection with SARS-CoV-2 in a patient undergoing chemotherapy for lymphoma: Case report

“…Unfortunately, immunosuppression induced by hematologic malignancies and certain medications (particularly rituximab [16]) are associated with lower rates of seroconversion from infection and vaccination (13). A number of case reports have also been published about reinfections in solid organ transplant patients (17,18) and recipients of immunomodulatory biologic therapies (19). Using two sets of serologic testing (NADAL IgG/IgM Test and Elecsys Anti-SARS-CoV-2 anti-N test), we were able to prove that our patient did not mount a detectable level of antibodies more than 50 days after his diagnosis (on February 7 and 18), while being actively infected.…”

The Prognostic Factors of Bloodstream Infection in Immunosuppressed Elderly Patients: A Retrospective, Single-center, Five-year Cohort Study

“…Immunosuppressed patients included the patients under immunosuppressive therapy (use of drugs like corticosteroids [prednisone equivalent > 20 mg/day] for at least 14 days, or methotrexate, cyclosporine, azathioprine, or biological modifiers within three months), posttransplantation includes solid-organ, stem cell, or bone marrow transplantation, cancer includes solid organ and hematological system tumors, burns, diabetes, liver cirrhosis, and critical postoperative condition. 5,[7][8][9][14][15][16] Exclusion criteria: patients age <65 years and incomplete data were excluded from the study.…”