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

Abstract

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.

Chronic Lung Allograft Dysfunction Is Associated with Significant Disability after Lung Transplantation—A Burden of Disease Analysis in 1025 Cases

“…Fourth, some of our patients were selected at the beginning of the COVID-19 pandemic, and the last visit of 489 patients still coincided with the first six months after the pandemic. Thus, as SARS-CoV-2 infection in LTx patients may result in a significant decline in lung function and a higher mortality [20,21], it cannot be excluded that the results of our study might have been impaired by COVID-19. However, only one COVID-19 patient was included in the study cohort, and they survived the disease without disability.…”

Low Mortality Associated with COVID-19 Infection in Lung Transplant Recipients at a Single Center

“…Mortality rates for LTRs who contracted COVID-19 infection ranged from 8-39% in observational case series [2,[4][5][6][7][8][9][10][11][12][13] In fact, current literature reports up to 8 times higher mortality rates associated with COVID in recipients of solid organ transplants, when compared to the general population [14]. Most of the observational studies on LTR with COVID-19 are from the earlier COVID-19 variant eras of the pandemic at which point treatment modalities were substantially more limited than there are available today.…”

Development and Validation of a High-Performance Liquid Chromatography with Tandem Mass Spectrometry (HPLC-MS/MS) Method for Quantification of Major Molnupiravir Metabolite (β-D-N4-hydroxycytidine) in Human Plasma

“…Although the WHO declared the end of the pandemic on 5 May 2023, COVID-19 remains a significant health threat [ 9 ]. Therefore, the development of drugs to treat COVID-19 should not lose its urgency.…”