Outcome of lung transplant recipients infected with SARS-CoV-2/Omicron/B.1.1.529: a Nationwide German study.


Journal

Infection
ISSN: 1439-0973
Titre abrégé: Infection
Pays: Germany
ID NLM: 0365307

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 07 07 2022
accepted: 25 08 2022
medline: 25 5 2023
pubmed: 10 9 2022
entrez: 9 9 2022
Statut: ppublish

Résumé

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is currently the major threat for immunocompromised individuals. The course of COVID-19 in lung transplant recipients in the Omicron era remains unknown. The aim of the study was to assess outcome and associated factors in lung transplant recipients in a German-wide multicenter approach. All affected individuals from January 1st to March 20th, 2022 from 8 German centers during the Omicron wave were collected. Baseline characteristics and antiviral measures were associated with outcome. Of 218 patients with PCR-proven SARS-CoV-2 infection 166 patients (76%) received any early (< 7 days) antiviral therapy median 2 (interquartile range 1-4) days after symptom onset. Most patients received sotrovimab (57%), followed by remdesivir (21%) and molnupiravir (21%). An early combination therapy was applied in 45 patients (21%). Thirty-four patients (16%) developed a severe or critical disease severity according to the WHO scale. In total, 14 patients (6.4%) died subsequently associated with COVID-19. Neither vaccination and antibody status, nor applied treatments were associated with outcome. Only age and glomerular filtration rate < 30 ml/min/1.73m COVID-19 due to Omicron remains an important threat for lung transplant recipients. In particular, elderly patients and patients with impaired kidney function are at risk for worse outcome. Prophylaxis and therapy in highly immunocompromised individuals need further improvement.

Identifiants

pubmed: 36083405
doi: 10.1007/s15010-022-01914-8
pii: 10.1007/s15010-022-01914-8
pmc: PMC9461411
doi:

Substances chimiques

Antiviral Agents 0

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

749-757

Informations de copyright

© 2022. The Author(s).

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Auteurs

Nikolaus Kneidinger (N)

Department of Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany. nikolaus.kneidinger@med.uni-muenchen.de.

Matthias Hecker (M)

Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus-Liebig University, Giessen, Germany.

Vasiliki Bessa (V)

Department of Pulmonary Medicine, West German Center for Lung Transplantation, University of Duisburg-Essen, Essen, Germany.

Ina Hettich (I)

Department of Pneumology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Alexandra Wald (A)

Department of Respiratory Medicine, University of Leipzig, Leipzig, Germany.

Sabine Wege (S)

Department of Pneumology and Critical Care Medicine, Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), Thoraxklinik at the University of Heidelberg, Heidelberg, Germany.

Anna-Barbara Nolde (AB)

Department of Respiratory Medicine, Eppendorf University Hospital, Hamburg, Germany.

Maike Oldigs (M)

Department of Pulmonology, Airway Research Center North, Member of the German Center for Lung Research (DZL), LungenClinic Grosshansdorf, Großhansdorf, Germany.

Zulfiya Syunyaeva (Z)

Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine and Cystic Fibrosis Center, Charité Universitätsmedizin Berlin, Berlin, Germany.

Heinrike Wilkens (H)

Department of Internal Medicine V, Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University, Homburg Saar, Germany.

Jens Gottlieb (J)

Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL), Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany.

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