COVID-19 in lung transplant recipients-Risk prediction and outcomes
Patients after lung transplantation are at risk for life-threatening infections. Recently, several publications on COVID-19 outcomes in this patient population appeared, but knowledge on optimal treatment, mortality, outcomes, and appropriate risk predictors is limited. A retrospective analysis was...
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| description | Patients after lung transplantation are at risk for life-threatening infections. Recently, several publications on COVID-19 outcomes in this patient population appeared, but knowledge on optimal treatment, mortality, outcomes, and appropriate risk predictors is limited. A retrospective analysis was performed in a German high-volume lung transplant center between 19th March 2020 and 18th May 2021. Impact of COVID-19 on physical and psychological health, clinical outcomes, and mortality were analyzed including follow-up visits up to 12 weeks after infection in survivors. Predictive parameters on survival were assessed using univariate and multivariate proportional hazards regression models. Out of 1,046 patients in follow-up, 31 acquired COVID-19 during the pandemic. 12 of 31 (39%) died and 26 (84%) were hospitalized. In survivors a significant decline in exercise capacity (p = 0.034), TLC (p = 0.02), and DLCO (p = 0.007) was observed at follow-up after 3 months. Anxiety, depression, and self-assessed quality of life remained stable. Charlson comorbidity index predicted mortality (HR 1.5, 1.1-2.2; p = 0.023). In recipients with pre-existing CLAD, mortality and clinical outcomes were inferior. However, pre-existing CLAD did not predict mortality. COVID-19 remains a life-threatening disease for lung transplant recipients, particularly in case comorbidities. Further studies on long term outcomes and impact on pre-existing CLAD are needed. |
| doi_str_mv | 10.1371/journal.pone.0257807 |
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Recently, several publications on COVID-19 outcomes in this patient population appeared, but knowledge on optimal treatment, mortality, outcomes, and appropriate risk predictors is limited. A retrospective analysis was performed in a German high-volume lung transplant center between 19th March 2020 and 18th May 2021. Impact of COVID-19 on physical and psychological health, clinical outcomes, and mortality were analyzed including follow-up visits up to 12 weeks after infection in survivors. Predictive parameters on survival were assessed using univariate and multivariate proportional hazards regression models. Out of 1,046 patients in follow-up, 31 acquired COVID-19 during the pandemic. 12 of 31 (39%) died and 26 (84%) were hospitalized. In survivors a significant decline in exercise capacity (p = 0.034), TLC (p = 0.02), and DLCO (p = 0.007) was observed at follow-up after 3 months. Anxiety, depression, and self-assessed quality of life remained stable. Charlson comorbidity index predicted mortality (HR 1.5, 1.1-2.2; p = 0.023). In recipients with pre-existing CLAD, mortality and clinical outcomes were inferior. However, pre-existing CLAD did not predict mortality. COVID-19 remains a life-threatening disease for lung transplant recipients, particularly in case comorbidities. Further studies on long term outcomes and impact on pre-existing CLAD are needed.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0257807</identifier><identifier>PMID: 34613977</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Biology and life sciences ; Comorbidity ; Complications and side effects ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; COVID-19 - mortality ; Disease susceptibility ; Evaluation ; Female ; Hazard assessment ; Health risks ; Humans ; Infections ; Lung diseases ; Lung transplantation ; Lung Transplantation - adverse effects ; Lungs ; Male ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Pandemics ; Patients ; Physical Sciences ; Quality assessment ; Quality of Life ; Regression analysis ; Regression models ; Retrospective Studies ; Risk ; Risk Factors ; SARS-CoV-2 - isolation & purification ; Survival ; Transplant Recipients ; Transplantation ; Transplantation of organs, tissues, etc ; Viral diseases</subject><ispartof>PloS one, 2021-10, Vol.16 (10), p.e0257807</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Kamp et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Kamp et al 2021 Kamp et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-bccee42351bb054fb4fe0812bcfe49cf75eda7baa251756d7a4eaca6f45f5b7f3</citedby><cites>FETCH-LOGICAL-c692t-bccee42351bb054fb4fe0812bcfe49cf75eda7baa251756d7a4eaca6f45f5b7f3</cites><orcidid>0000-0002-5002-409X ; 0000-0003-2926-3608</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494359/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494359/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23853,27911,27912,53778,53780,79355,79356</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34613977$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Chen, Robert Jeenchen</contributor><creatorcontrib>Kamp, Jan C</creatorcontrib><creatorcontrib>Hinrichs, Jan B</creatorcontrib><creatorcontrib>Fuge, Jan</creatorcontrib><creatorcontrib>Ewen, Raphael</creatorcontrib><creatorcontrib>Gottlieb, Jens</creatorcontrib><title>COVID-19 in lung transplant recipients-Risk prediction and outcomes</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Patients after lung transplantation are at risk for life-threatening infections. Recently, several publications on COVID-19 outcomes in this patient population appeared, but knowledge on optimal treatment, mortality, outcomes, and appropriate risk predictors is limited. A retrospective analysis was performed in a German high-volume lung transplant center between 19th March 2020 and 18th May 2021. Impact of COVID-19 on physical and psychological health, clinical outcomes, and mortality were analyzed including follow-up visits up to 12 weeks after infection in survivors. Predictive parameters on survival were assessed using univariate and multivariate proportional hazards regression models. Out of 1,046 patients in follow-up, 31 acquired COVID-19 during the pandemic. 12 of 31 (39%) died and 26 (84%) were hospitalized. In survivors a significant decline in exercise capacity (p = 0.034), TLC (p = 0.02), and DLCO (p = 0.007) was observed at follow-up after 3 months. Anxiety, depression, and self-assessed quality of life remained stable. 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Recently, several publications on COVID-19 outcomes in this patient population appeared, but knowledge on optimal treatment, mortality, outcomes, and appropriate risk predictors is limited. A retrospective analysis was performed in a German high-volume lung transplant center between 19th March 2020 and 18th May 2021. Impact of COVID-19 on physical and psychological health, clinical outcomes, and mortality were analyzed including follow-up visits up to 12 weeks after infection in survivors. Predictive parameters on survival were assessed using univariate and multivariate proportional hazards regression models. Out of 1,046 patients in follow-up, 31 acquired COVID-19 during the pandemic. 12 of 31 (39%) died and 26 (84%) were hospitalized. In survivors a significant decline in exercise capacity (p = 0.034), TLC (p = 0.02), and DLCO (p = 0.007) was observed at follow-up after 3 months. Anxiety, depression, and self-assessed quality of life remained stable. Charlson comorbidity index predicted mortality (HR 1.5, 1.1-2.2; p = 0.023). In recipients with pre-existing CLAD, mortality and clinical outcomes were inferior. However, pre-existing CLAD did not predict mortality. COVID-19 remains a life-threatening disease for lung transplant recipients, particularly in case comorbidities. Further studies on long term outcomes and impact on pre-existing CLAD are needed.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34613977</pmid><doi>10.1371/journal.pone.0257807</doi><tpages>e0257807</tpages><orcidid>https://orcid.org/0000-0002-5002-409X</orcidid><orcidid>https://orcid.org/0000-0003-2926-3608</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Aged Biology and life sciences Comorbidity Complications and side effects Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 - mortality Disease susceptibility Evaluation Female Hazard assessment Health risks Humans Infections Lung diseases Lung transplantation Lung Transplantation - adverse effects Lungs Male Medicine and Health Sciences Middle Aged Mortality Pandemics Patients Physical Sciences Quality assessment Quality of Life Regression analysis Regression models Retrospective Studies Risk Risk Factors SARS-CoV-2 - isolation & purification Survival Transplant Recipients Transplantation Transplantation of organs, tissues, etc Viral diseases |
| title | COVID-19 in lung transplant recipients-Risk prediction and outcomes |
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