COVID-19 in lung transplant recipients-Risk prediction and outcomes.
Jan-Christopher KampJan B HinrichsJan FugeRaphael EwenJens GottliebPublished in: PloS one (2021)
Patients after lung transplantation are at risk for life-threatening infections. Recently, several publications on COVID-19 outcomes in this patient population appeared, but knowledge on optimal treatment, mortality, outcomes, and appropriate risk predictors is limited. A retrospective analysis was performed in a German high-volume lung transplant center between 19th March 2020 and 18th May 2021. Impact of COVID-19 on physical and psychological health, clinical outcomes, and mortality were analyzed including follow-up visits up to 12 weeks after infection in survivors. Predictive parameters on survival were assessed using univariate and multivariate proportional hazards regression models. Out of 1,046 patients in follow-up, 31 acquired COVID-19 during the pandemic. 12 of 31 (39%) died and 26 (84%) were hospitalized. In survivors a significant decline in exercise capacity (p = 0.034), TLC (p = 0.02), and DLCO (p = 0.007) was observed at follow-up after 3 months. Anxiety, depression, and self-assessed quality of life remained stable. Charlson comorbidity index predicted mortality (HR 1.5, 1.1-2.2; p = 0.023). In recipients with pre-existing CLAD, mortality and clinical outcomes were inferior. However, pre-existing CLAD did not predict mortality. COVID-19 remains a life-threatening disease for lung transplant recipients, particularly in case comorbidities. Further studies on long term outcomes and impact on pre-existing CLAD are needed.
Keyphrases
- coronavirus disease
- sars cov
- end stage renal disease
- cardiovascular events
- chronic kidney disease
- ejection fraction
- healthcare
- newly diagnosed
- risk factors
- respiratory syndrome coronavirus
- physical activity
- peritoneal dialysis
- coronary artery disease
- mental health
- public health
- metabolic syndrome
- patient reported outcomes
- case report
- sleep quality
- extracorporeal membrane oxygenation
- health information
- combination therapy
- data analysis
- human health