COVID-19 in Lung Transplant Recipients.

Messika, Jonathan; Eloy, Philippine; Roux, Antoine; Hirschi, Sandrine; Nieves, Ana; Le Pavec, Jérôme; Sénéchal, Agathe; Saint Raymond, Christel; Carlier, Nicolas; Demant, Xavier; Le Borgne, Aurélie; Tissot, Adrien; Debray, Marie-Pierre; Beaumont, Laurence; Renaud-Picard, Benjamin; Reynaud-Gaubert, Martine; Mornex, Jean-François; Falque, Loïc; Boussaud, Véronique; Jougon, Jacques; Mussot, Sacha; Mal, Hervé

BACKGROUND A concern about the susceptibility of immunocompromised patients to the worldwide pandemic of coronavirus disease 2019 (COVID-19) has been raised. We aimed at describing COVID-19 infections in the French cohort of lung transplant (LT) patients. METHODS Multicenter nationwide cohort study of all LT recipients with COVID-19 diagnosed from March 1 to May 19, 2020. Recipient main characteristics and their management were retrieved. Hospitalization characteristics, occurrence of complications and survival were analyzed. RESULTS Thirty-five LT patients with a COVID-19 infection were included. Median age was 50.4 [40.6-62.9] years, 16 (45.7%) were female, and 80% were double-LT recipients. Infection was community-acquired in 25 (71.4%). Thirty-one (88.6%) required hospitalization, including 13 (41.9%) in the intensive care unit. The main symptoms of COVID-19 were fever, cough, and diarrhea, present in 71.4%, 54.3%, and 31.4% of cases, respectively. Extension of pneumonia on chest CT was moderate to severe in 51.4% of cases. Among the 13 critically ill patients, 7 (53.9%) received invasive mechanical ventilation. Thrombotic events occurred in 4 patients. Overall survival rate was 85.7% after a median follow-up of 50 days [41.0-56.5]. Four of 5 nonsurvivors had had bronchial complications or intensification of immunosuppression in the previous weeks. On univariate analysis, overweight was significantly associated with risk of death (odds ratio 16.0 [95% confidence interval1.5-170.6], p=0.02). CONCLUSION For the 35 LT recipients with COVID-19, the presentation was severe, requiring hospitalization in most cases, with a survival rate of 85.7%.