(696) Low Covid-19 Related Mortality Among Lung Transplant Recipients at a Single Center

• Published in: The Journal of heart and lung transplantation Vol. 42; no. 4; pp. S308 - S309
• Main Authors: Gomez, R.F., Kafi, A., Yung, G., Aslam, S., Pollema, T., Golts, E., Lin, C., Afshar, K.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2023; Published by Elsevier Inc
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2023.02.710

The omicron variant era led to a dramatic increase in COVID-19 infection in lung transplant recipients (LTR). We previously described our experience with COVID-19 in LTR during the wild type and delta variant eras. Here we provide an update on short and intermediate term outcomes of COVID-19 infections in LTR. This is a single-center retrospective study of all LTR at the University of California San Diego with COVID-19 infections between June 2020 and September 2022. Patient demographic data, immunosuppression regimen, and hospital course were recorded. Subsequent spirometry, imaging, biopsy results and interventions were also obtained (Table 1). 72 LTR with PCR-confirmed COVID-19 infection were included. 45 (62.5%) were male, 39 (54.2%) were Caucasian, and 56 (77.8%) had double-LT. 56 (73.6%) had symptomatic infections, 27 (37.5%) required hospitalization, including 7 (9.7%) requiring ICU admission and 1 (1.4%) requiring extracorporeal membrane oxygenation. The median drop in FEV1 and FVC at 3 months was 2.4% and 2.5%, respectively. Post-infection ACR and death were seen in 3 (4.2%) patients. Of the 3 deaths, 2 were due to COVID-19 infection in LTRs with stage 3 chronic lung allograft dysfunction (CLAD). The remaining death was related to failure to thrive and occurred months after COVID infection. The omicron era of COVID-19 led to a nearly 5-fold increase in COVID-19 infections among LTR. Despite the higher prevalence of COVID-19 infection, the mortality in our cohort remained low compared to other published reports of COVID-19 infection in LTR. Compared to our prior analysis which included only wild type and delta variant eras, the rates of mortality and ACR both decreased from 11.8% to 4.2%. This improvement in post COVID-19 outcomes may be attributable to monoclonal antibody therapy, increased vaccination, pre exposure prophylaxis and changes in viral virulence. Larger studies are needed to assess the impact of the various COVID-19 variants on LTRs.