Treatment of Patients After Lung Transplantation With Covid Infection During Long-Term Follow-Up.
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Żegleń S, Nagajewski A, Górski D, Wojarski J, Karlsen W, Akily L, Sunesson F, Sawczuk M, Nojek R, Lipka K, Gallas M, Dukat-Mazurek A, Karolak W
Transplant Proc - (-) - [2024-05-06; online 2024-05-06]
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.
PubMed 38714369
DOI 10.1016/j.transproceed.2024.03.010
Crossref 10.1016/j.transproceed.2024.03.010
pii: S0041-1345(24)00180-5