COVID-19 infection is mild and has minimal impact on lung function in well vaccinated and widely treated lung transplant recipients.

Publication date: Feb 24, 2024

COVID-19 has become a common infection affecting lung transplant recipients (LTR), who are at high risk for poor outcomes. Outcomes early in the pandemic were poor, but since the rollout of vaccination and novel COVID-19 treatments, outcomes of LTR have not been well described. Our aim was to evaluate the effect of COVID-19 on the clinical course and lung function trajectory in an Australian cohort of LTR. Data was retrospectively collected from LTR with confirmed COVID-19 managed at Alfred Health, between August 2020 and December 2022. Baseline demographics, COVID-19 disease details (including severity) and spirometry pre and post infection have been analysed. A total of 279 LTR were included. The cohort was comorbid, but well vaccinated, with 275/279 (98. 6%) having >2 COVID-19 vaccines at symptom onset. Severe disease occurred in only 17 cases (6%) and overall mortality was very low (4%). Prompt treatment with antivirals, particularly remdesevir (OR 0. 18, 95% CI 0. 04-0. 81, p=0. 02] and vaccination (OR 0. 24, CI 0. 08-0. 81, p=0. 01] were protective. There was not a clinically significant drop in lung function post COVID-19 with the median absolute decline in forced expiratory volume (FEV1) being 40mL (IQR 5-120mL, p10% occurring in only 42 patients (17%). After multivariate adjustment, only rejection prior to COVID-19 was significantly associated with FEV1 decline afterwards (OR 3. 74, 1. 12-11. 86, p=0. 03). In our highly COVID-19 vaccinated, promptly treated LTR, the majority of COVID-19 infections were mild and did not result in a clinically significant decline in lung function.

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Concepts Keywords
August COVID-19
Australian immunosuppression
December lung transplant
Severe solid organ transplant


Type Source Name
disease MESH COVID-19
disease MESH infection
disease VO vaccinated
disease VO vaccination
disease MESH clinical course
disease IDO symptom
disease VO volume
disease MESH Long Covid
disease IDO immunosuppression

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