Post-COVID interstitial lung disease in symptomaticpatients after hospital discharge

COVID-19 is often associated with long-lasting pulmonary symptoms. Data are scarce about interstitial lung disease(ILD) in patients following COVID-19 hospitalization with persistent symptoms.We retrospectively reviewed all cases sent to pulmonary post-COVID evaluation due to persistent symptomsbetween February 2021 and February 2022 (N=318). All patients with suspected ILD (N=44) were reviewed at theMDD. Patient characteristics, symptoms, time since hospitalization, lung function, PI and PE, and 6-minutewalk test (6MWT) were evaluated.The post-COVID-ILD included more men (male: 68%, age: 64.0+/-12.3 years, time since hospitalization: 2.4+/-2.3months) with overweight (BMI 29.1+/-4.2 kg/m2). Persisting symptoms included tiredness (30%), dyspnea (20%),cough (20%), sleep disorders (20%). Spirometry confirmed a mild restrictive ventilatory pattern (FVC: 76.7+/-18.1,FEV1: 83.5+/-19.1 TLC: 85.6+/-28.1 %pred) while average PI and PE was normal. 6MWT confirmed desaturationin 41% of cases.maxmaxmaxmax Our data indicate that suspected post-COVID ILD is affecting 13.8% of symptomatic patients. Functional impairment, especially desaturation during 6MWT is an important factor when ILD is suspected. Longitudinal follow-up of these patients is in progress.

Serological response following second and third SARSCoV-2 vaccines in lung transplant recipients

Introduction: Lung transplant recipients (LuTX) represent a vulnerable patient population for the new SARS-CoV-2 infection (severe acute respiratory syndrome coronavirus 2). Even though many vaccines are already developed, there is a few knowledge with non-mRNA vaccines in LuTX patients. Method(s): Stable LuTX recipients at least one year after transplantation were enrolled. Patients who had new coronavirus infection were excluded. Currently available (BNT162b2-mRNA, mRNA-1273, ChAdOx1 and BBIBPCorV) vaccines were given randomly, third doses were mRNA-based vaccines. SARS-CoV-2 Spike1 IgG antibody titer was evaluated before vaccination and 2 weeks after the second and third doses. Result(s): Forty-one LuTX recipients (49% men, 48.4+/-13.8 years) received minimum 2 doses of vaccines, 19 from them vaccinated with non-mRNA vaccines. 24 patients also had third dose. Positive serology was found in 37% of the patients after the second dose and 52% from all became positive after the third vaccine. The average level of Spike1 antibody among the patients with positive serology was 1894 U/ml [range 3.29-5797 U/ml] after the third dose. Six patients vaccinated with two mRNA-based vaccine developed moderate disease in average of 178 days and 3 of them died in ICU. No serious adverse events were observed. Conclusion(s): Immunosuppression therapy may induce weaker SARS-CoV-2 response in LuTX recipients. Our data confirm that non-mRNA vaccines could be safe and effective, however immunity decreases over time, therefore third dose vaccine is a priority in transplanted patients. Further data are needed to evaluate cellular responses after all type of SARS-CoV-2 vaccinations.

SARS-CoV2 vaccination in Hungarian IPF patients

Introduction: SARS-CoV2 infection is associated with significant risk of coronavirus disease (COVID-19) and represents a significant risk factor for functional deterioration in idiopathic pulmonary fibrosis (IPF) patients. Method(s): We retrospectively reviewed all IPF patients treated at our university center for their SARS-CoV2 vaccination status starting from January 2021 in Hungary. Result(s): Total of 68 (out of treated 70 IPF patients) received minimum 2 doses of SARS-CoV2 vaccines (male 52.85%, age: 72.24 +/- 9.65 years), 20 of them were vaccinated with non-mRNA vaccines (BBIBP-CorV-Sinopharm, ChAdOx1-AstraZeneca, Gam-Covid-Vac-Sputnik and Ad26. COV2.S-Janssen), while 48 with mRNA vaccines. Majority (N=57) of patients also took a third dose: most patients received BNT162b2-mRNA-Pfizer/Biontech (58.82%), followed by BBIBP-CorV and mRNA-1273-Moderna (both 11.76 %). There were no hospitalizations for COVID-19 in the vaccinated group, regardless of the type of the vaccine received and no significant adverse event was detected. One of the non-vaccinated patients (2 women, age 70 and 73 years) died in COVID-19 pneumonia. IPF patients were mainly in a good functional state (FVC = 2.52 +/- 1.03 L;78.81 +/- 22.72%) with reduced diffusion capacity (TLCO = 5.28 +/- 2.11 mmol/kPa/min;66.28 +/- 21.58%). Conclusion(s): SARS-CoV2 vaccination is utmost important in IPF patients, and independent of vaccine type used it resulted in significantly decreased risk of COVID-19 hospitalization.