Limited data is currently available regarding the course of COVID-19 in lung and solid organ transplant recipients. We hereby present 4 cases of SARS-CoV-2 pneumonia in lung transplant recipients from our centre, set in Milan, Italy. We reduced immunosuppressive regimen in all these patients, typically holding the antiproliferative agent and augmenting steroids; everybody received hydroxychloroquine, initial empiric antibiotic treatment with piperacillin/tazobactam and high dose low molecular weight heparin. Clinical course seemed favourable in three of our patients, but one of them deteriorated after 10 days of hospitalization, probably due to an acute form of graft dysfunction triggered both by COVID19 and a nosocomial bacterial infection, and eventually died. Although short-term prognosis could be considered benign in the majority of our patients, we should carefully monitor these individuals in order to detect early sign of clinical deterioration and graft dysfunction in the next few months.
COVID-19 In Lung Transplant Recipients: A Case Series From Milan, Italy.