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Sars-cov-2 infections in four lung transplant recipients: A single-center experience
Transplant International ; 33(SUPPL 2):18, 2020.
Article in English | EMBASE | ID: covidwho-1093815
ABSTRACT

Introduction:

To date, 23 lung transplant recipients have been described with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections worldwide. Eight had severe coronavirus disease 2019 (COVID-19), but none were placed on extracorporeal membrane oxygenation (ECMO) support. We aimed to describe our experience.

Methods:

Lung transplant recipients who were admitted to our hospital with SARS-CoV-2 infections from the beginning of the pandemia until May 25th, 2020 were included. Clinical charts were retrospectively retrieved and data analysed.

Results:

Four patients (3 males, 75%) with a median age of 58.5 years (47-66) were admitted for SARS-CoV-2 infections in our center. Three patients had double-lung transplantation for chronic thromboembolic pulmonary hypertension, idiopathic pulmonary fibrosis and cystic fibrosis. One patient had singlelung transplantation for non-specific interstitial pneumonia. SARS-CoV-2 infections were diagnosed by nasopharyngeal swabs in all patients within one month post-transplant (n=2), or after 13 months (n=1) and 15 years (n=1). Dyspnea was present in all patients. Worsening of symptoms occurred in three patients after a median of 8 days (1 to 8) after diagnosis. Imaging showed a highly variable degree of infiltrations. Mechanical ventilation was required in three patients. They all underwent prone positioning. Veno-venous ECMO was required in two patients. In all patients, immunosuppression consisted of prednisone and tacrolimus, while mycophenolate mofetil was stopped. Treatment with hydroxychloroquine was attempted in the first three patients. At last follow-up, one patient was discharged home and one was weaned from mechanical ventilation. Both ECMO supported patients died from multiple organ failure, despite ECMO could be weaned in one patient.

Conclusion:

A highly variable course of COVID-19 disease was observed in four patients after lung transplantation. More data is needed to better understand prognostic factors and management of this patient cohort.

Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Transplant International Year: 2020 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Transplant International Year: 2020 Document Type: Article