There are limited data describing COVID-19 in lung transplant recipients. We performed a single center, retrospective case series study of lung transplant patients followed by the Columbia Lung Transplant program who tested positive for SARS-CoV-2 between March 19-May 19, 2020. 32 lung transplant patients developed mild (16%), moderate (44%), or severe (41%) COVID-19. The median age of patients was 65 years, and the median time from lung transplant was 5.6 years. Symptoms included cough (66%), dyspnea (50%), fever (47%), and gastrointestinal upset (44%). Patients received hydroxychloroquine (84%), azithromycin (75%), augmented steroids (44%), tocilizumab (19%), and remdesivir (9%). 11 patients (34%) died at a median time of 14 days from admission. Complications during admission included: acute kidney injury (63%), transaminitis (31%), shock (31%), acute respiratory distress syndrome (25%), neurological events (25%), arrhythmias (22%), and venous thromboembolism (9%). Compared to patients with moderate COVID-19, patients with severe COVID-19 had higher peak white blood cell counts (15.8 vs. 7 x 103/uL, p=0.019), C-reactive protein (198 vs. 107 mg/L, p=0.010) and D-dimer (8.6 vs. 2.1 ug/mL, p=0.004) levels, and lower nadir lymphocyte counts (0.09 vs. 0.4x 103/uL, p=0.006). COVID-19 is associated with severe illness and a high mortality rate in lung transplant recipients.
COVID-19 in lung transplant recipients: A single center case series from New York City