COVID-19 Vaccination in Lung Transplant Recipients

Altneu, Eric; Mishkin, Aaron

doi:10.1007/s12055-022-01364-9

Cited by 5 publications

(3 citation statements)

References 43 publications

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“…They also found a less relevant immune response after the first two doses of vaccination. These findings are corroborated by Altneu et al, who also support the need for a fourth dose in recipients, especially those infected with the Omicron variant [ 9 ]. In Case #2, the patient was already suffering from significant bilateral bronchial stenosis, and COVID-19 contributed to accelerating the process of respiratory deterioration.…”

Section: Discussionsupporting

confidence: 58%

Lung Transplant Recipients and COVID-19: Report of Two Cases

Antonacci

Petroncini

Salvaterra

et al. 2023

JCM

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Although the WHO has declared the end of the pandemic emergency, COVID-19 still poses a threat to immunocompromised patients. The COVID-19 pandemic has spread throughout the world over the last two years, causing a significant number of deaths. After three years, SARS-CoV-2 has lost its initial lethality but has shown a significantly worse prognosis for immunocompromised patients, especially those who have undergone lung transplantation, compared with the general population. This paper presents two compelling case studies that highlight the complex challenges of COVID-19 infection in lung transplant recipients. The first case involves a patient who received a bilateral lung transplant for pulmonary artery hypertension in 2009, followed by a kidney transplant in 2022. Surprisingly, despite an initially favorable clinical course after contracting COVID-19, the patient deteriorated rapidly and died within a few days due to extensive lung involvement. This case highlights the unpredictable nature of COVID-19 and its potentially devastating impact on lung transplant recipients. The second case involves a patient who underwent bilateral lung transplantation five years earlier for chronic obstructive pulmonary disease (COPD). This individual also contracted COVID-19 and had pre-existing complications, including chronic lung allograft rejection (CLAD) and diffuse bronchial stenosis. Following viral infection, the patient’s clinical condition deteriorated rapidly, with worsening bronchial stenosis. This case highlights the ability of COVID-19 to exacerbate pre-existing pulmonary complications in transplant recipients. These cases highlight the urgent need for increased vigilance and tailored management strategies when dealing with COVID-19 in lung transplant recipients. The unpredictable and detrimental course of the disease observed in these patients highlights the importance of implementing stringent preventive measures, such as vaccination and strict adherence to infection control protocols, in this vulnerable population. Further research is essential to gain a full understanding of the unique dynamics of COVID-19 in lung transplant recipients and to develop targeted interventions to improve their outcomes.

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Section: Discussionsupporting

confidence: 58%

Lung Transplant Recipients and COVID-19: Report of Two Cases

Antonacci

Petroncini

Salvaterra

et al. 2023

JCM

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“…All types of immunosuppressive drugs have different mechanisms of action that when combined will severely blunt the immune response. CNI blocks T-cell activation and proliferation, MMF impairs the proliferation of B and T lymphocytes and increases apoptosis, while corticosteroids mainly affect T lymphocytes by impairing their development, survival, activation, and migration [36].…”

Section: Discussionmentioning

confidence: 99%

COVID-Related Chronic Allograft Dysfunction in Lung Transplant Recipients: Long-Term Follow-up Results from Infections Occurring in the Pre-vaccination Era

Hage

Schuurmans

2022

Transplantology

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Introduction: We report on characteristics and lung function outcomes among lung transplant recipients (LTRs) after COVID-19 with infections occurring in the first year of the coronavirus pandemic prior to introduction of the vaccines. Methods: This was a retrospective study of 18 LTRs who tested positive for SARS-CoV-2 between 1 February 2020 and 1 March 2021. The mean age was 49.9 (22–68) years; 12 patients (67%) were male. Two patients died due to severe COVID-19. Results: During the study period, there were 18 lung transplant recipients with a community-acquired SARS-CoV-2 infection. In this cohort, seven had mild, nine had moderate, and two had severe COVID-19. All patients with mild and moderate COVID-19 survived, but the two patients with severe COVID-19 died in the intensive care unit while intubated and on mechanical ventilation. Most patients with moderate COVID-19 showed a permanent lung function decrease that did not improve after 12 months. Conclusion: A majority of LTRs in the current cohort did not experience an alteration in the trajectory of FEV1 evolution after developing SARS-CoV-2 infection. However, in the patients with moderate COVID-19, most patients had a decline in the FEV1 that was present after 1 month after recovery and did not improve or even deteriorated further after 12 months. In LTRs, COVID-19 can have long-lasting effects on pulmonary function. Treatment strategies that influence this trajectory are needed.

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“…[1]". Corona virus disease-19 (COVID-19) vaccination in transplant recipients generates a lower protective response when compared to immunocompetent hosts, according to Altneu and Mishkin [1]. The appropriate number of COVID doses and timing, according to Altneu and Mishkin, is still unknown, with new findings pointing to the requirement for a fourth mRNA vaccine [1].…”

mentioning

confidence: 99%

COVID-19 vaccination and lung transplant recipients

Mungmunpuntipantip¹,

Wiwanitkit

2022

Indian J Thorac Cardiovasc Surg

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We would like to correspond on the publication "COVID-19 vaccination in lung transplant recipients. [1]". Corona virus disease-19 (COVID-19) vaccination in transplant recipients generates a lower protective response when compared to immunocompetent hosts, according to Altneu and Mishkin [1]. The appropriate number of COVID doses and timing, according to Altneu and Mishkin, is still unknown, with new findings pointing to the requirement for a fourth mRNA vaccine [1]. We agree that COVID-19 vaccination is beneficial to lung transplant recipients, and clinical evidence backs this up. However, the likely effect of asymptomatic COVID-19 is a significant confounding factor in several studies. Infection with COVID-19 is common, and the virus can re-infect people without generating symptoms [2]. COVID-19 may become asymptomatic, making the efficacy of the vaccination in past trials more difficult to establish due to immunological abnormalities. The potential of asymptomatic COVID-19 must be ruled out before a firm determination can be reached. Regardless of whether COVID-19 is asymptomatic, the immunisation can induce immunity. For transplant recipients, a booster immunisation is frequently required. The fourth dosage of COVID-19 vaccination is presently being administered to the general public in various countries, including Israel. The use of the fourth dosage of COVID-19 vaccination is also beneficial, according to a prior study [3]. As a result, lung transplant recipients may consider receiving a fourth dose of COVID-19 vaccination.

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COVID-19 Vaccination in Lung Transplant Recipients

Cited by 5 publications

References 43 publications

Lung Transplant Recipients and COVID-19: Report of Two Cases

Lung Transplant Recipients and COVID-19: Report of Two Cases

COVID-Related Chronic Allograft Dysfunction in Lung Transplant Recipients: Long-Term Follow-up Results from Infections Occurring in the Pre-vaccination Era

COVID-19 vaccination and lung transplant recipients

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