Treatment of Patients After Lung Transplantation With Covid Infection During Long-Term Follow-Up.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
06 May 2024
Historique:
received: 30 12 2023
accepted: 26 03 2024
medline: 8 5 2024
pubmed: 8 5 2024
entrez: 7 5 2024
Statut: aheadofprint

Résumé

Patients undergoing lung transplantation are routinely managed with lifelong immunosuppression, which is associated with a heightened risk for infections. This study delves into the therapeutic challenges and strategies for managing lung transplant recipients (LTRs) infected with COVID-19 during long-term follow-up. The was a case series analysis, among which nonstandard therapies consisting of targeted antibody treatment, antiviral drugs, or anti-interleukin-6 drugs were applied in patients after lung transplantation. Additional analysis of laboratory test results for systemic inflammation and imaging studies was also carried out. The study was limited to a dedicated COVID-19 center, commonly known as a temporary hospital, and included patients infected with COVID-19 in the late post-lung transplant period (home-related infection). Fifteen post-lung transplantation patients with current COVID-19 infection were treated with antibodies such as tocilizumab, casirivimab, imdevimab, and regdanvimab. Of these patients, 1 was given tocilizumab (7%), 8 casirivimab and imdevimab (53%), and 2 regdanvimab (13%). Of the 15 lung transplant recipients studied, 8 presented COVID-19-associated lung changes in computed tomography scans (53%). Common clinical manifestations included dyspnea, fever, and fatigue. Antiviral agents, like remdesivir, were employed in the remaining 4 cases (27%), and adjunctive therapies, such as corticosteroids and anticoagulants, were used selectively. All treated patients survived the infection without complications; the treatment proved effective and safe.

Sections du résumé

BACKGROUND BACKGROUND
Patients undergoing lung transplantation are routinely managed with lifelong immunosuppression, which is associated with a heightened risk for infections. This study delves into the therapeutic challenges and strategies for managing lung transplant recipients (LTRs) infected with COVID-19 during long-term follow-up.
METHODS METHODS
The was a case series analysis, among which nonstandard therapies consisting of targeted antibody treatment, antiviral drugs, or anti-interleukin-6 drugs were applied in patients after lung transplantation. Additional analysis of laboratory test results for systemic inflammation and imaging studies was also carried out. The study was limited to a dedicated COVID-19 center, commonly known as a temporary hospital, and included patients infected with COVID-19 in the late post-lung transplant period (home-related infection).
RESULTS RESULTS
Fifteen post-lung transplantation patients with current COVID-19 infection were treated with antibodies such as tocilizumab, casirivimab, imdevimab, and regdanvimab. Of these patients, 1 was given tocilizumab (7%), 8 casirivimab and imdevimab (53%), and 2 regdanvimab (13%). Of the 15 lung transplant recipients studied, 8 presented COVID-19-associated lung changes in computed tomography scans (53%). Common clinical manifestations included dyspnea, fever, and fatigue. Antiviral agents, like remdesivir, were employed in the remaining 4 cases (27%), and adjunctive therapies, such as corticosteroids and anticoagulants, were used selectively. All treated patients survived the infection without complications; the treatment proved effective and safe.

Identifiants

pubmed: 38714369
pii: S0041-1345(24)00180-5
doi: 10.1016/j.transproceed.2024.03.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest All the authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Sławomir Żegleń (S)

Department of Pneumonology and Allergology, Medical University of Gdansk, Poland. Electronic address: slawomir.zeglen@gumed.edu.pl.

Adam Nagajewski (A)

Temporary Hospital - Szczytno, Department of Internal Diseases and Infectious Diseases, Szczytno, Poland.

Dominik Górski (D)

Temporary Hospital - Szczytno, Department of Internal Diseases and Infectious Diseases, Szczytno, Poland.

Jacek Wojarski (J)

Depatment of Cardiac Surgery, Medical University of Gdańsk, Poland.

William Karlsen (W)

Scientific Circle of Lung Transplantology, Department of Lung Transplantation, Medical University of Gdansk, Poland.

Lin Akily (L)

Scientific Circle of Lung Transplantology, Department of Lung Transplantation, Medical University of Gdansk, Poland.

Fanny Sunesson (F)

Emergency Department of Surgery (KAVA), Kristianstad, Sweden.

Marcin Sawczuk (M)

Depatment of Cardiac Surgery, Medical University of Gdańsk, Poland.

Rafał Nojek (R)

Department of Applied Computer Science, AGH University of Science and Technology in Krakow, Poland.

Karolina Lipka (K)

Depatment of Cardiac Surgery, Medical University of Gdańsk, Poland.

Marta Gallas (M)

Institute of Nursing and Midwifery, Department of Nursing Management, Medical University of Gdansk, Poland.

Anna Dukat-Mazurek (A)

Department of Medical Immunology, Medical University of Gdansk, Poland.

Wojtek Karolak (W)

Depatment of Cardiac Surgery, Medical University of Gdańsk, Poland.

Classifications MeSH