Coronavirus Disease 2019 Causing Infection of Transplanted Lung Allograft: A Pitfall of Prolonged Shedding of Severe Acute Respiratory Syndrome Coronavirus-2 Pretransplant

• Published in: Mayo Clinic proceedings. Innovations, quality & outcomes Vol. 7; no. 2; pp. 93 - 98
• Main Authors: Shah, Sadia Z., Alvarez, Francisco G., Sanghavi, Devang K., Moreno Franco, Pablo, Isha, Shahin, Marquez, Christopher P., Libertin, Claudia, Guru, Pramod K., Sareyyupoglu, Basar, Pham, Si M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.04.2023; Elsevier
• Subjects: COVID-19; NPS; CT; SARS-CoV-2; RT-PCR; LT; BSL-3; BAL; CP; VV-ECMO; CP, convalescent plasma; BSL-3, Biosafety level-3; LT, lung transplant; BAL, bronchoalveolar lavage; COVID-19, coronavirus disease 2019; CT, computed tomography; VV-ECMO, veno-venous extracorporeal membrane oxygenation; RT-PCR, reverse transcriptase–polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; NPS, nasopharyngeal swab
• ISSN: 2542-4548; 2542-4548
• DOI: 10.1016/j.mayocpiqo.2023.01.001

Coronavirus disease 2019 (COVID-19) pandemic has led to considerable morbidity and mortality across the world. Lung transplant is a viable option for a few with COVID-19–related lung disease. Whom and when to transplant has been the major question impacting the transplant community given the novelty of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a pitfall of presumed prolonged shedding of SARS-CoV-2 in a patient with COVID-19 associated acute respiratory distress syndrome leading to COVID-19 pneumonia after lung transplant. This raises concerns that replication-competent SARS-CoV-2 virus can persist for months post-infection and can lead to re-infection of grafts in the future.