Systemic corticosteroids for outpatient respiratory viral infections in lung transplant recipients.

glucocorticoid lung transplantation spirometry therapeutics viruses

Journal

Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688

Informations de publication

Date de publication:
03 Nov 2023
Historique:
revised: 22 09 2023
received: 26 06 2023
accepted: 15 10 2023
medline: 3 11 2023
pubmed: 3 11 2023
entrez: 3 11 2023
Statut: aheadofprint

Résumé

Respiratory viral infections (RVI) in lung transplant recipients (LTR) have variably been associated with rejection and chronic lung allograft dysfunction. Our center has used systemic corticosteroids to treat outpatient RVI in some cases, but evidence is limited. We reviewed all adult LTR diagnosed with outpatient RVI January 2017 to December 2019. The primary outcome was recovery of lung function (forced expiratory volume in 1 s [FEV1]) at next stable visit between 1 and 12 months postinfection, expressed as a ratio over stable preinfection FEV1 (FEV1 recovery ratio). We identified 100 adult LTR with outpatient RVI diagnoses eligible for study, 36% of whom received corticosteroids. We modelled the adjusted association between corticosteroid use and FEV1 recovery ratio using linear regression. Steroid-treated patients had a lower FEV1 presentation ratio (0.92 vs. 1.04, p = .0070) and were more likely to have chronic lung allograft dysfunction at time of infection (25% vs. 5%, p = .0077). Mean FEV1 recovery ratio was 1.02 (SD 0.19) with no association with corticosteroid therapy via multivariable linear regression (p = .5888). Steroid treatment was not associated with FEV1 recovery. This suggests corticosteroids may not have a role in the management of RVI in this population.

Identifiants

pubmed: 37922374
doi: 10.1111/tid.14181
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e14181

Informations de copyright

© 2023 Wiley Periodicals LLC.

Références

Kumar D, Erdman D, Keshavjee S, et al. Clinical impact of community-acquired respiratory viruses on bronchiolitis obliterans after lung transplant. Am J Transplant. 2005;5(8):2031-2036. doi:10.1111/j.1600-6143.2005.00971.x
Irwin RS, Madison JM. Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. New Engl J Medicine. 2003;348(26):2679-2681. doi:10.1056/nejme030034
Wedzicha J. Oral corticosteroids for exacerbations of chronic obstructive pulmonary disease. Thorax. 2000;55(suppl 1):S23. doi:10.1136/thorax.55.suppl_1.s23
Fisher CE, Preiksaitis CM, Lease ED, et al. Symptomatic respiratory virus infection and chronic lung allograft dysfunction. Clin Infect Dis. 2016;62(3):313-319. doi:10.1093/cid/civ871
Pelaez A, Lyon GM, Force SD, et al. Efficacy of oral ribavirin in lung transplant patients with respiratory syncytial virus lower respiratory tract infection. J Heart Lung Transplant. 2009;28(1):67-71. doi:10.1016/j.healun.2008.10.008
Kumar D, Husain S, Chen MH, et al. A prospective molecular surveillance study evaluating the clinical impact of community-acquired respiratory viruses in lung transplant recipients. Transplantation. 2010;89(8):1028-1033. doi:10.1097/tp.0b013e3181d05a71
Manuel O, Estabrook M, American Society of Transplantation Infectious Diseases Community of Practice. RNA respiratory viral infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13511. doi:10.1111/ctr.13511
Kurai D, Saraya T, Ishii H, Takizawa H. Virus-induced exacerbations in asthma and COPD. Front Microbiol. 2013;4:293. doi:10.3389/fmicb.2013.00293
Horby P, Lim WS, Emberson JR, et al. Dexamethasone in hospitalized patients with Covid-19. New Engl J Med. 2020;384(8):693-704. doi:10.1056/nejmoa2021436
Rhen T, Cidlowski JA. Antiinflammatory action of glucocorticoids-new mechanisms for old drugs. New Engl J Medicine. 2005;353(16):1711-1723. doi:10.1056/nejmra050541
Price D, Castro M, Bourdin A, Fucile S, Altman P. Short-course systemic corticosteroids in asthma: striking the balance between efficacy and safety. Eur Respir Rev. 2020;29(155):190151. doi:10.1183/16000617.0151-2019
Thomas BJ, Porritt RA, Hertzog PJ, Bardin PG, Tate MD. Glucocorticosteroids enhance replication of respiratory viruses: effect of adjuvant interferon. Sci Rep-uk. 2014;4(1):7176. doi:10.1038/srep07176
Bradley MC, Perez-Vilar S, Chillarige Y, et al. Systemic corticosteroid use for COVID-19 in US outpatient settings from April 2020 to August 2021. JAMA. 2022;327(20):2015-2018. doi:10.1001/jama.2022.4877
Verleden GM, Glanville AR, Lease ED, et al. Chronic Lung allograft dysfunction: definition, diagnostic criteria and approaches to treatment. A Consensus Report from the Pulmonary Council of the ISHLT. J Heart Lung Transplant. 2019;38(5):493-503. doi:10.1016/j.healun.2019.03.009
Burrows FS, Carlos LM, Benzimra M, et al. Oral ribavirin for respiratory syncytial virus infection after lung transplantation: Efficacy and cost-efficiency. J Heart Lung Transplant. 2015;34(7):958-962. doi:10.1016/j.healun.2015.01.009
Lederer DJ, Bell SC, Branson RD, et al. Control of confounding and reporting of results in causal inference studies. guidance for authors from editors of respiratory, sleep, and critical care journals. Ann Am Thorac Soc. 2018;16(1):22-28. doi:10.1513/annalsats.201808-564ps
Lin KJ, Dvorin E, Kesselheim AS. Prescribing systemic steroids for acute respiratory tract infections in United States outpatient settings: a nationwide population-based cohort study. Plos Med. 2020;17(3):e1003058. doi:10.1371/journal.pmed.1003058
Dvorin EL, Lamb MC, Monlezun DJ, Boese AC, Bazzano LA, Price-Haywood EG. high frequency of systemic corticosteroid use for acute respiratory tract illnesses in ambulatory settings. Jama Intern Med. 2018;178(6):852. doi:10.1001/jamainternmed.2018.0103
Manuel O, Estabrook M, AST Infectious Diseases Community of Practice. RNA respiratory viruses in solid organ transplantation. Am J Transplant. 2013;13(s4):212-219. doi:10.1111/ajt.12113
Bitterman R, Kumar D. Respiratory viruses in solid organ transplant recipients. Viruses. 2021;13(11):2146. doi:10.3390/v13112146
Zhou Y, Fu X, Liu X, et al. Use of corticosteroids in influenza-associated acute respiratory distress syndrome and severe pneumonia: a systemic review and meta-analysis. Sci Rep-uk. 2020;10(1):3044. doi:10.1038/s41598-020-59732-7
Shuto H, Komiya K, Yamasue M, et al. A systematic review of corticosteroid treatment for noncritically ill patients with COVID-19. Sci Rep-uk. 2020;10(1):20935. doi:10.1038/s41598-020-78054-2
Khalifah AP, Khalifah AP, Hachem RR, et al. Respiratory viral infections are a distinct risk for bronchiolitis obliterans syndrome and death. Am J Resp Crit Care. 2004;170(2):181-187. doi:10.1164/rccm.200310-1359oc
Fuehner T, Simon A, Dierich M, et al. Indicators for steroid response in biopsy proven acute graft rejection after lung transplantation. Resp Med. 2009;103(8):1114-1121. doi:10.1016/j.rmed.2009.03.013
Levine SM, Physicians on behalf of TTN of the AC of C. A Survey of Clinical Practice of Lung Transplantation in North America. Chest. 2004;125(4):1224-1238. doi:10.1378/chest.125.4.1224
Zwart A de, Riezebos-Brilman A, Lunter G, et al. Respiratory syncytial virus, human metapneumovirus, and parainfluenza virus infections in lung transplant recipients: a systematic review of outcomes and treatment strategies. Clin Infect Dis. 74(12):2252-2260:2021. doi:10.1093/cid/ciab969
Bailey ES, Zemke JN, Choi JY, Gray GC. A mini-review of adverse lung transplant outcomes associated with respiratory viruses. Front Immunol. 2019;10:2861. doi:10.3389/fimmu.2019.02861
Zwart AES, Riezebos-Brilman A, Alffenaar JC, et al. Evaluation of 10 years of parainfluenza virus, human metapneumovirus, and respiratory syncytial virus infections in lung transplant recipients. Am J Transplant. 2020;20(12):3529-3537. doi:10.1111/ajt.16073
Peghin M, Los-Arcos I, Hirsch HH, et al. Community-acquired respiratory viruses are a risk factor for chronic lung allograft dysfunction. Clin Infect Dis Official Publ Infect Dis Soc Am. 2019;69(7):1192-1197. doi:10.1093/cid/ciy1047

Auteurs

Vardhil Ghandi (V)

Department of Medicine, University of Alberta, Edmonton, Canada.

David Li (D)

Department of Medicine, University of Alberta, Edmonton, Canada.

Justin Weinkauf (J)

Department of Medicine, University of Alberta, Edmonton, Canada.

Dale Lien (D)

Department of Medicine, University of Alberta, Edmonton, Canada.

Alim Hirji (A)

Department of Medicine, University of Alberta, Edmonton, Canada.

Rhea Varughese (R)

Department of Medicine, University of Alberta, Edmonton, Canada.

Jason Weatherald (J)

Department of Medicine, University of Alberta, Edmonton, Canada.

Wendy Sligl (W)

Department of Medicine, University of Alberta, Edmonton, Canada.

Dima Kabbani (D)

Department of Medicine, University of Alberta, Edmonton, Canada.

Ilan Schwartz (I)

Department of Medicine, University of Alberta, Edmonton, Canada.

Karen Doucette (K)

Department of Medicine, University of Alberta, Edmonton, Canada.

Carlos Cervera (C)

Department of Medicine, University of Alberta, Edmonton, Canada.

Kieran Halloran (K)

Department of Medicine, University of Alberta, Edmonton, Canada.

Classifications MeSH