Infectious Complications of Lung Transplant for Coronavirus Disease 2019-Associated Lung Injury: A Single-Center Case-Control Cohort Study.

Autor:	Osborn R; Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Alamri M; Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Tomic R; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Ison MG; Respiratory Diseases Branch, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, Rockville, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 Jul 26; Vol. 77 (2), pp. 220-228.
DOI:	10.1093/cid/ciad160
Abstrakt:	Background: Lung transplantation is one of the only options for patients with severe coronavirus disease 2019 (COVID-19)-associated lung injury (CALI). Studies on patients who received a lung transplant for CALI have, to date, not looked at the infectious outcomes. Methods: After institutional review board approval, a retrospective case-control cohort study, matched 1:1, collected data on patients who underwent lung transplantation for CALI (case) and for non-COVID-19 end-stage lung disease (control) between 1 June 2020 and 1 April 2022 at a large academic hospital in Chicago. We assessed infectious complications and other key outcomes pre-transplant and for 1 year post-transplant. Results: Among 78 patients (39 CALI and 39 matched control lung transplant patients), those in the CALI cohort were less likely to be vaccinated pre-transplant and were more likely to have diabetes, to be obese, to not be ambulatory, and to require pre-transplant extracorporeal membrane oxygenation and mechanical ventilation. Patients transplanted for CALI had higher rates of infection pre-transplant (66.7% vs 15.4% of patients in the control) and in the first 30 days post-transplant (43.6% vs 20.5%). Numbers and types of infection were similar in both groups at other time points. One-year mortality was similar for CALI and control groups (12.8% vs 10.3%, respectively). Conclusions: Patients who received a lung transplant for CALI are more deconditioned with prolonged hospital stays and experience more infectious complications immediately pre- and post-transplant. Infections due to multidrug-resistant organisms are important contributors to morbidity and mortality in this population. Antimicrobial stewardship is urgently needed. Competing Interests: Potential conflicts of interest. RO and MA have no COI. M. G. I. recieved grants from GSK (research support paid to Northwestern University); reports royalties or licenses from UptoDate and consulting fees from Adagio, ADMA Biologics, Adamis, AlloVir, Atea, Cidara, Genentech, Janssen, Roche, Shionogi, Takeda, Telaris, and Viracor Eurofins; and is the chair for ISIRV AVG and editor-in-chief from Transplant Infectious Disease. R. T. received support from Boehringer Ingelheim. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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