Jonathan Messika1,2,3, Philippine Eloy4,5, Antoine Roux3,6,7, Sandrine Hirschi8, Ana Nieves9, Jérôme Le Pavec10,11,12, Agathe Sénéchal13, Christel Saint Raymond14, Nicolas Carlier15, Xavier Demant16, Aurélie Le Borgne17, Adrien Tissot18, Marie-Pierre Debray19, Laurence Beaumont6, Benjamin Renaud-Picard8, Martine Reynaud-Gaubert9, Jean-François Mornex13,20, Loïc Falque14, Véronique Boussaud15, Jacques Jougon16, Sacha Mussot10,11,12, Hervé Mal1,2. 1. Hôpital Bichat-Claude Bernard, Service de Pneumologie B et Transplantation Pulmonaire, APHP.Nord-Université de Paris, Paris, France. 2. Physiopathology and Epidemiology of Respiratory Diseases, UMR1152 INSERM and Université de Paris, Paris, France. 3. Paris Transplant Group, Paris, France. 4. AP-HP, Hôpital Bichat, DEBRC, Paris, France. 5. INSERM, CIC-EC 1425, Hôpital Bichat, Paris, France. 6. Pneumology, Adult Cystic Fibrosis Center and Lung Transplantation Department, Foch Hospital, Suresnes, France. 7. Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France. 8. Pneumology Unit and Strasbourg Lung Transplant Program, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. 9. Service de Pneumologie, Équipe de Transplantation Pulmonaire, CHU Nord-APHM, Aix-Marseille Université, Marseille, France. 10. School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France. 11. INSERM UMR_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, France. 12. Department Transplantation, Thoracic and Vascular Surgery, Pulmonary Hypertension National Referral Center, Groupe Hospitalier Paris Saint Joseph, Hôpital Marie Lannelongue, Le Plessis Robinson, France. 13. Service de Pneumologie, Hôpital Louis Pradel, Bron, France. 14. Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France. 15. Service de Pneumologie, Hôpital Cochin, APHP.CUP, Paris, France. 16. Service des Maladies Respiratoires, Hôpital Haut-Lévêque, CHU Bordeaux, Bordeaux, France. 17. Service de Pneumologie, Pôle des voies respiratoires, Hôpital Larrey, CHU Toulouse, Toulouse, France. 18. Service de Pneumologie, CHU de Nantes, Nantes, France. 19. Inserm UMR1152 Physiopathology and Epidemiology of Respiratory Diseases, Service de Radiologie, Hôpital Bichat Claude Bernard, APHP Nord, Paris, France. 20. Université Lyon 1, INRAE, IVPC, UMR754, Université de Lyon, Lyon, France.
Abstract
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 interval, 1.5-170.6; P = 0.02). CONCLUSIONS: For the 35 LT recipients with COVID-19, the presentation was severe, requiring hospitalization in most cases, with a survival rate of 85.7%.
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 interval, 1.5-170.6; P = 0.02). CONCLUSIONS: For the 35 LT recipients with COVID-19, the presentation was severe, requiring hospitalization in most cases, with a survival rate of 85.7%.
Authors: Arnaud G L'Huillier; Lara Danziger-Isakov; Abanti Chaudhuri; Michael Green; Marian G Michaels; Klara M Posfay-Barbe; Dimitri van der Linden; Anita Verma; Mignon McCulloch; Monica I Ardura Journal: Pediatr Transplant Date: 2021-03-10
Authors: Madeleine R Heldman; Olivia S Kates; Kassem Safa; Camille N Kotton; Sarah J Georgia; Julie M Steinbrink; Barbara D Alexander; Marion Hemmersbach-Miller; Emily A Blumberg; Maria M Crespo; Ashrit Multani; Angelica V Lewis; Omer Eugene Beaird; Brandy Haydel; Ricardo M La Hoz; Lisset Moni; Yesabeli Condor; Sandra Flores; Carlos G Munoz; Juan Guitierrez; Esther I Diaz; Daniela Diaz; Rodrigo Vianna; Giselle Guerra; Matthias Loebe; Robert M Rakita; Maricar Malinis; Marwan M Azar; Vagish Hemmige; Margaret E McCort; Zohra S Chaudhry; Pooja Singh; Kailey Hughes; Arzu Velioglu; Julie M Yabu; Jose A Morillis; Sapna A Mehta; Sajal D Tanna; Michael G Ison; Rade Tomic; Ariella Candace Derenge; David van Duin; Adrienne Maximin; Carlene Gilbert; Jason D Goldman; Sameep Sehgal; Dana Weisshaar; Reda E Girgis; Joanna Nelson; Erika D Lease; Ajit P Limaye; Cynthia E Fisher Journal: Am J Transplant Date: 2021-07-24 Impact factor: 9.369