Background

Concerns have been raised on the impact of coronavirus disease (COVID-19) on lung transplant (LTx) patients. The aim of this study was to evaluate the transplant function pre- and post-COVID-19 in LTx patients.

Methods

Data were retrospectively collected from LTx patients with confirmed COVID-19 from all 3 Dutch transplant centers, between February 2020 and September 2021. Spirometry results were collected pre-COVID-19, 3- and 6-months post infection.

Results

Seventy-four LTx patients were included. Forty-two (57%) patients were admitted, 19 (26%) to the intensive care unit (ICU). The in-hospital mortality was 20%. Twelve out of 19 ICU patients died (63%), a further 3 died on general wards. Patients with available spirometry (78% at 3 months, 65% at 6 months) showed a significant decline in mean forced expiratory volume in 1 second (FEV1) (ΔFEV1 138 ± 39 ml, p = 0.001), and forced vital capacity (FVC) (ΔFVC 233 ±74 ml, p = 0.000) 3 months post infection. Lung function improved slightly from 3 to 6 months after COVID-19 (ΔFEV1 24 ± 38 ml; ΔFVC 100 ± 46 ml), but remained significantly lower than pre-COVID-19 values (ΔFEV1 86 ml ± 36 ml, p = 0.021; ΔFVC 117 ± 35 ml, p = 0.012). FEV1/FVC was > 0.70.

Conclusions

In LTx patients COVID-19 results in high mortality in hospitalized patients. Lung function declined 3 months after infection and gradually improved at 6 months, but remained significantly lower compared to pre-COVID-19 values. The more significant decline in FVC than in FEV1 and FEV1/FVC > 70%, suggested a more restrictive pattern.

中文翻译：

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COVID-19 对肺移植患者移植功能和 CLAD 发展的影响：多中心经验

背景

人们对冠状病毒病 (COVID-19) 对肺移植 (LTx) 患者的影响提出了担忧。本研究的目的是评估 LTx 患者在 COVID-19 前后的移植功能。

方法

在 2020 年 2 月至 2021 年 9 月期间，从荷兰所有 3 个移植中心的确诊 COVID-19 的 LTx 患者中回顾性收集了数据。肺量测定结果是在 COVID-19 前、感染后 3 个月和 6 个月收集的。

结果

包括 74 名 LTx 患者。42 名 (57%) 患者入院，19 名 (26%) 入住重症监护病房 (ICU)。住院死亡率为20%。19 名 ICU 患者中有 12 名（63%）死亡，另有 3 名在普通病房死亡。具有可用肺活量测定的患者（3 个月时为 78%，6 个月时为 65%）显示平均 1 秒用力呼气量 (FEV1) (ΔFEV1 138 ± 39 ml, p  = 0.001) 和用力肺活量 (FVC ) 显着下降) (ΔFVC 233 ±74 ml, p  = 0.000) 感染后 3 个月。COVID-19 后 3 至 6 个月肺功能略有改善（ΔFEV1 24 ± 38 ml；ΔFVC 100 ± 46 ml），但仍显着低于 COVID-19 之前的值（ΔFEV1 86 ml ± 36 ml，p  = 0.021；ΔFVC 117 ± 35mL，p = 0.012)。FEV1/FVC > 0.70。

结论

在 LTx 患者中，COVID-19 导致住院患者的高死亡率。肺功能在感染后 3 个月下降，并在 6 个月时逐渐改善，但与 COVID-19 之前的值相比仍显着降低。FVC 的下降比 FEV1 和 FEV1/FVC > 70% 的下降更显着，表明模式更具限制性。