COVID-19 in lung transplant recipients: A multicenter study.

Saez-Giménez, Berta; Berastegui, Cristina; Barrecheguren, Miriam; Revilla-López, Eva; Los Arcos, Ibai; Alonso, Rodrigo; Aguilar, Myriam; Mora, Víctor Manuel; Otero, Isabel; Reig, Juan Pablo; Quezada, Carlos Andrés; Pérez, Virginia; Valle, Manuel; Laporta, Rosalía; Deu, María; Sacanell, Judith; Bravo, Carles; Gavalda, Joan; Lopez-Meseguer, Manuel; Monforte, Víctor

This study describes the clinical presentation, treatment, and outcomes of SARS-CoV-2 infection in lung transplant recipients (LTRs). This is a multicenter, retrospective study of all adult LTRs with confirmed SARS-CoV-2 infection from March 4th until April 28th , 2020 in six Spanish reference hospitals for lung transplantation. Clinical and radiological data, treatment characteristics, and outcomes were reviewed. Forty-four cases were identified in that period. The median time from transplantation was 4.2 (interquartile range: 1.11-7.3) years. Chest radiography showed acute parenchymal abnormalities in 32 (73%) cases. Hydroxychloroquine was prescribed in 41 (93%), lopinavir/ritonavir in 14 (32%), and tocilizumab in 19 (43%) patients. There was a strong interaction between tacrolimus and lopinavir/ritonavir in all cases. Thirty-seven (84%) patients required some degree of respiratory support and/or oxygen therapy, and 13 (30%) were admitted to intermediate or intensive critical care units. Seventeen (39%) patients had died and 20 (45%) had been discharged at the time of the last follow-up. Deceased patients had a worse respiratory status and chest X-ray on admission and presented with higher D-dimer, interleukin-6, and lactate dehydrogenase levels. In this multi-center LTR cohort, SARS-Cov-2 presented with high mortality. Additionally, the severity of disease on presentation predicted subsequent mortality.