Can SARSCov2 infection drive in an acute rejection in lung transplant recipients?

Objective: to describe the clinical presentation and outcomes of COVID-19 in lung transplant recipients (LTRs) when managed with high-dose corticosteroids along with standard therapy. Method(s): all nine (9) adult LTRs with confirmed SARS-CoV-2 infection and chest X-ray with predominant bilateral infiltrates and hypoxemia, treated with high-doses corticosteroids similar to an acute rejection treatment were included. All our treated patients presented acute respiratory failure and bilateral pulmonary infiltrates. Result(s): six (6) out of nine (9) patients (66%) treated with bolus evolved favorably. Patients without corticosteroids treatment and severe disease died. Despite lymphopenia and methylprednisolone pulse therapy there were no infectious complications. As per protocol antiviral, bacterial and fungal prophylaxis was prescribed during this period. RT- PCR took long time in becoming negative. Patients who received megadoses of corticosteroids were more likely to live than those who received low doses Conclusion(s): COVID-19 in lung transplant recipients with acute respiratory failure presents a favorable outcome when is managed with high-doses corticosteroids along with standard therapy.

Short-term neuropsychiatric outcomes and quality of life in COVID-19 survivors.

BACKGROUND: The general medical impacts of coronavirus (COVID-19) are increasingly appreciated. However, its impact on neurocognitive, psychiatric health and quality of life (QoL) in survivors after the acute phase is poorly understood. We aimed to evaluate neurocognitive function, psychiatric symptoms and QoL in COVID-19 survivors shortly after hospital discharge. METHODS: This was a cross-sectional analysis of a prospective study of hospitalized COVID-19 survivors followed up for 2 months after discharge. A battery of standardized instruments evaluating neurocognitive function, psychiatric morbidity and QoL (mental and physical components) was administered by telephone. RESULTS: Of the 229 screened patients, 179 were included in the final analysis. Amongst survivors, the prevalence of moderately impaired immediate verbal memory and learning was 38%, delayed verbal memory (11.8%), verbal fluency (34.6%) and working memory (executive function) (6.1%), respectively. Moreover, 58.7% of patients had neurocognitive impairment in at least one function. Rates of positive screening for anxiety, depression and post-traumatic stress disorder were 29.6%, 26.8% and 25.1%, respectively. In addition, 39.1% of the patients had psychiatric morbidity. Low QoL for physical and mental components was detected in 44.1% and 39.1% of patients respectively. Delirium and psychiatric morbidity were associated with neurocognitive impairment, and female gender was related with psychiatric morbidity. CONCLUSION: Hospitalized COVID-19 survivors showed a considerable prevalence of neurocognitive impairment, psychiatric morbidity and poor QoL in the short term. It is uncertain if these impacts persist over the long term.