COVID-19 pneumonia in lung transplant recipients: Report of 2 cases

Am J Transplant. 2020 Oct;20(10):2933-2937. doi: 10.1111/ajt.15993. Epub 2020 Jun 14.

Abstract

Coronavirus disease 2019 (COVID-19) has been declared pandemic since March 2020. In Europe, Italy was the first nation affected by this infection. We report anamnestic data, clinical features, and therapeutic management of 2 lung transplant recipients with confirmed COVID-19 pneumonia. Both patients were in good clinical condition before the infection and were receiving immunosuppression with calcineurin inhibitors (CNI), mycophenolate mofetil, and corticosteroids. Whereas mycophenolate mofetil was withdrawn in both cases, CNI were suspended only in the second patient. The first patient always maintained excellent oxygen saturation throughout hospitalization with no need for additional oxygen therapy. He was discharged with a satisfactory pulmonary function and a complete resolution of radiological and clinical findings. However, at discharge SARS-CoV-2 RNA could still be detected in the nasopharyngeal swab and in the stools. The second patient required mechanical ventilation, had a progressive deterioration of his clinical conditions, and had a fatal outcome. Further insight into SARS-CoV-2 infection is eagerly awaited to improve the outcome of transplant recipients affected by COVID-19 pneumonia.

Keywords: clinical research/practice; immunosuppressant; immunosuppression/immune modulation; infection and infectious agents - viral; lung disease: infectious; lung transplantation/pulmonology.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / therapy
  • Coronavirus Infections / transmission
  • Cystic Fibrosis / surgery
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lung Transplantation / methods*
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / therapy
  • Pneumonia, Viral / transmission
  • Postoperative Period
  • Pulmonary Disease, Chronic Obstructive / surgery
  • Respiration, Artificial
  • SARS-CoV-2
  • Tomography, X-Ray Computed
  • Transplant Recipients*

Substances

  • Immunosuppressive Agents