COVID-19 in lung transplant recipients: A single center case series from New York City

被引:56
作者
Aversa, Meghan [1 ]
Benvenuto, Luke [1 ]
Anderson, Michaela [1 ]
Shah, Lori [1 ]
Robbins, Hilary [1 ]
Pereira, Marcus [2 ]
Scheffert, Jenna [3 ]
Carroll, Maggie [1 ]
Hum, Jamie [1 ]
Nolan, Margaret [1 ]
Reilly, Genevieve [1 ]
Lemaitre, Philippe [4 ]
Stanifer, Bryan P. [4 ]
D'Ovidio, Frank [4 ]
Sonett, Joshua [4 ]
Arcasoy, Selim [1 ]
机构
[1] Columbia Univ, Div Pulm Allergy & Crit Care Med, Dept Med, Med Ctr, New York, NY 10027 USA
[2] Columbia Univ, Div Infect Dis, Dept Med, Med Ctr, New York, NY USA
[3] New York Presbyterian Hosp, Dept Pharm, New York, NY USA
[4] Columbia Univ, Div Thorac Surg, Dept Surg, Med Ctr, New York, NY USA
关键词
D O I
10.1111/ajt.16241
中图分类号
R61 [外科手术学];
学科分类号
摘要
There are limited data describing COVID-19 in lung transplant recipients. We performed a single center, retrospective case series study of lung transplant patients followed by the Columbia Lung Transplant program who tested positive for SARS-CoV-2 between March 19 and May 19, 2020. Thirty-two lung transplant patients developed mild (16%), moderate (44%), or severe (41%) COVID-19. The median age of patients was 65 years, and the median time from lung transplant was 5.6 years. Symptoms included cough (66%), dyspnea (50%), fever (47%), and gastrointestinal upset (44%). Patients received hydroxychloroquine (84%), azithromycin (75%), augmented steroids (44%), tocilizumab (19%), and remdesivir (9%). Eleven patients (34%) died at a median time of 14 days from admission. Complications during admission included: acute kidney injury (63%), transaminitis (31%), shock (31%), acute respiratory distress syndrome (25%), neurological events (25%), arrhythmias (22%), and venous thromboembolism (9%). Compared to patients with moderate COVID-19, patients with severe COVID-19 had higher peak white blood cell counts (15.8 vs 7 x 10(3)/uL,P = .019), C-reactive protein (198 vs. 107 mg/L,P = .010) and D-dimer (8.6 vs. 2.1 ug/mL,P = .004) levels, and lower nadir lymphocyte counts (0.09 vs. 0.4 x 10(3)/uL,P = .006). COVID-19 is associated with severe illness and a high mortality rate in lung transplant recipients.
引用
收藏
页码:3072 / 3080
页数:9
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