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Lung transplantation for patients with severe COVID-19.
Bharat, Ankit; Querrey, Melissa; Markov, Nikolay S; Kim, Samuel; Kurihara, Chitaru; Garza-Castillon, Rafael; Manerikar, Adwaiy; Shilatifard, Ali; Tomic, Rade; Politanska, Yuliya; Abdala-Valencia, Hiam; Yeldandi, Anjana V; Lomasney, Jon W; Misharin, Alexander V; Budinger, G R Scott.
  • Bharat A; Division of Thoracic Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. abharat@nm.org.
  • Querrey M; Division of Thoracic Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Markov NS; Division of Pulmonary and Critical Care Medicine, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Kim S; Division of Thoracic Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Kurihara C; Division of Thoracic Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Garza-Castillon R; Division of Thoracic Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Manerikar A; Division of Thoracic Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Shilatifard A; Department of Biochemistry and Molecular Genetics, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Tomic R; Division of Pulmonary and Critical Care Medicine, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Politanska Y; Division of Pulmonary and Critical Care Medicine, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Abdala-Valencia H; Division of Pulmonary and Critical Care Medicine, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Yeldandi AV; Department of Pathology, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Lomasney JW; Department of Pathology, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Misharin AV; Division of Pulmonary and Critical Care Medicine, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
  • Budinger GRS; Division of Pulmonary and Critical Care Medicine, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Sci Transl Med ; 12(574)2020 12 16.
Article in English | MEDLINE | ID: covidwho-1207479
Semantic information from SemMedBD (by NLM)
1. Lung Transplantation TREATS COVID-19
Subject
Lung Transplantation
Predicate
TREATS
Object
COVID-19
2. Lung Transplantation TREATS Patients
Subject
Lung Transplantation
Predicate
TREATS
Object
Patients
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Lung Transplantation TREATS Respiratory Failure
Subject
Lung Transplantation
Predicate
TREATS
Object
Respiratory Failure
5. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
6. Lung LOCATION_OF Pneumoni
Subject
Lung
Predicate
LOCATION_OF
Object
Pneumoni
7. Pathogenic organism CAUSES Pneumoni
Subject
Pathogenic organism
Predicate
CAUSES
Object
Pneumoni
8. Lung LOCATION_OF Biopsy
Subject
Lung
Predicate
LOCATION_OF
Object
Biopsy
9. Transplantation TREATS Patients
Subject
Transplantation
Predicate
TREATS
Object
Patients
10. Disease PROCESS_OF Patients
Subject
Disease
Predicate
PROCESS_OF
Object
Patients
11. Lung PART_OF Patients
Subject
Lung
Predicate
PART_OF
Object
Patients
12. Pulmonary Fibrosis PROCESS_OF Patients
Subject
Pulmonary Fibrosis
Predicate
PROCESS_OF
Object
Patients
13. Fibrotic lung disease PROCESS_OF Patients
Subject
Fibrotic lung disease
Predicate
PROCESS_OF
Object
Patients
14. Lung Transplantation TREATS COVID-19
Subject
Lung Transplantation
Predicate
TREATS
Object
COVID-19
15. Lung Transplantation TREATS Patients
Subject
Lung Transplantation
Predicate
TREATS
Object
Patients
16. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
17. Lung Transplantation TREATS Respiratory Failure
Subject
Lung Transplantation
Predicate
TREATS
Object
Respiratory Failure
18. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
19. Lung LOCATION_OF Pneumonia, Ventilator-Associated
Subject
Lung
Predicate
LOCATION_OF
Object
Pneumonia, Ventilator-Associated
20. Pathogenic organism CAUSES Pneumonia, Ventilator-Associated
Subject
Pathogenic organism
Predicate
CAUSES
Object
Pneumonia, Ventilator-Associated
21. Lung LOCATION_OF Biopsy
Subject
Lung
Predicate
LOCATION_OF
Object
Biopsy
22. Transplantation TREATS Patients
Subject
Transplantation
Predicate
TREATS
Object
Patients
23. Disease PROCESS_OF Patients
Subject
Disease
Predicate
PROCESS_OF
Object
Patients
24. Lung PART_OF Patients
Subject
Lung
Predicate
PART_OF
Object
Patients
25. Pulmonary Fibrosis PROCESS_OF Patients
Subject
Pulmonary Fibrosis
Predicate
PROCESS_OF
Object
Patients
26. Fibrotic lung disease PROCESS_OF Patients
Subject
Fibrotic lung disease
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
Lung transplantation can potentially be a life-saving treatment for patients with nonresolving COVID-19-associated respiratory failure. Concerns limiting lung transplantation include recurrence of SARS-CoV-2 infection in the allograft, technical challenges imposed by viral-mediated injury to the native lung, and the potential risk for allograft infection by pathogens causing ventilator-associated pneumonia in the native lung. Additionally, the native lung might recover, resulting in long-term outcomes preferable to those of transplant. Here, we report the results of lung transplantation in three patients with nonresolving COVID-19-associated respiratory failure. We performed single-molecule fluorescence in situ hybridization (smFISH) to detect both positive and negative strands of SARS-CoV-2 RNA in explanted lung tissue from the three patients and in additional control lung tissue samples. We conducted extracellular matrix imaging and single-cell RNA sequencing on explanted lung tissue from the three patients who underwent transplantation and on warm postmortem lung biopsies from two patients who had died from COVID-19-associated pneumonia. Lungs from these five patients with prolonged COVID-19 disease were free of SARS-CoV-2 as detected by smFISH, but pathology showed extensive evidence of injury and fibrosis that resembled end-stage pulmonary fibrosis. Using machine learning, we compared single-cell RNA sequencing data from the lungs of patients with late-stage COVID-19 to that from the lungs of patients with pulmonary fibrosis and identified similarities in gene expression across cell lineages. Our findings suggest that some patients with severe COVID-19 develop fibrotic lung disease for which lung transplantation is their only option for survival.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Fibrosis / Lung Transplantation / COVID-19 / Lung Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Scitranslmed.abe4282

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Fibrosis / Lung Transplantation / COVID-19 / Lung Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Scitranslmed.abe4282