Four Cases of COVID-19 Infection in Lung Transplant Recipients

Türkkan, S.; Sahin, M. F.; Beyoglu, M. A.; Yazicioglu, A.; Tekce, Y. T.; Yekeler, E.

Introduction There are limited data about short and long-term problems caused by COVID-19 infection in lung transplant and other organ transplant recipients.We share the clinical,laboratory,radiological and treatment results of four lung transplant recipients after COVID-19 infection who were operated in our clinic. Case Report All patients had positive PCR tests for COVID-19,three of four patients had dyspnea and desaturation with ground glass areas on thorax CT.One patient only complained of impaired sense of smell.Three patients with signs of pneumonia were hospitalized and one patient was treated on an outpatient basis.While one of the patients received a combine therapy with favipiravir.hydroxychloroquine,azithromycin,3 patients received only favipiravir treatment.Three consecutive days of 1000 mg/day methylprednisolone treatment were used in 3 patients with signs of pneumonia and dyspnea,because symptoms did not improve.Death was not observed in any of the cases.The complaint of the patient,who had symptoms of impaired sense of smell,resolved within 5 days.Three patients with persistent dyspnea,desaturation,and radiological symptoms showed improvement in symptoms and radiological findings after pulse steroid therapy.In one of the cases,it was observed that the lesions caused interseptal thickening in the control tomography scan performed after three months. Summary There is limited data about the treatment and long-term results of Covid-19 infection.High dose steroid therapy may be a safe chose for the treatment of COVID-19 infection with signs of pneumonia in organ transplant recipients.However, further studies are needed to determine whether the disease leaves sequelae fibrotic areas in the lung or triggers /accelerates the CLAD process seen after lung transplantation.