Abstract
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 × 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 × 10 3 /uL, P = .006). COVID-19 is associated with severe illness and a high mortality rate in lung transplant recipients.
【초록키워드】 COVID-19, SARS-CoV-2, Azithromycin, Hydroxychloroquine, severe COVID-19, acute respiratory distress syndrome, Tocilizumab, Remdesivir, C-reactive protein, D-dimer, Acute kidney injury, cough, Steroids, Venous Thromboembolism, Moderate COVID-19, arrhythmia, Lymphocyte count, lymphocyte, Shock, White blood cell, Transplant, Fever, Dyspnea, Patient, Complication, Mild, Arrhythmias, Admission, moderate, lung transplant, acute respiratory distress, retrospective, neurological, steroid, followed by, blood cell, respiratory distress, during admission, recipients, median time, median age, syndrome, transaminitis, single center, high mortality rate, positive, event, tested, performed, died, case sery, patients with moderate, the median, 【제목키워드】 COVID-19, New York City, lung transplant, case sery,