COVID-19 infection in a lung transplant recipient
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COVID-19 infection in a lung transplant recipient

Yuan Zeng1,2,3,4#, Guilin Peng1,2,3,4#, Chao Yang1,2,3,4, Mengyang Liu1,2,3,4, Jianxing He1,2,3,4, Xin Xu1,2,3,4

1Department of Organ Transplantation, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; 2Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; 3Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China; 4National Clinical Research Center for Respiratory Disease, Guangzhou, China

#These authors contributed equally to this work.

Correspondence to: Jianxing He, MD, PhD; Xin Xu, MD, PhD. Department of Organ Transplantation, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, No. 151, Yanjiang Rd., Guangzhou 510120, China; National Clinical Research Center for Respiratory Disease, Guangzhou, China. Email: drhe_jianxing@163.com; yichunrenjia@126.com.

Submitted Dec 08, 2023. Accepted for publication Mar 01, 2024. Published online Apr 12, 2024.

doi: 10.21037/jtd-23-1869

A 64-year-old man with chronic obstructive pulmonary disease (COPD) underwent a right lung transplantation three years ago. He was presented to the emergency department with severe dyspnea and coronavirus disease 2019 (COVID-19) infection was detected by throat swab. At admission, the patient’s heart rate was 92 beats per minute, blood oxygen saturation was 91%, and breathing was 24 beats per minute under low flow oxygen supply. Computed tomography (CT) of the chest showed imaging changes consistent with interstitial pneumonia in the right lung graft; the left emphysematous findings were essentially unchanged (Figure 1). Figure 2 shows a CT scan of the chest 3 months before the COVID-19 infection for regular follow-up. The patient developed severe acute respiratory distress syndrome during hospitalization with an oxygenation index of 162 mmHg. The patient was treated with continuous ventilator assisted ventilation in an intermittently prone position with nirmatrelvir tablets/ritonavir tablets, Solu-Medrol, and tocilizumab injections. The patient’s conditions improved 1 month after the treatment and was discharged to home. A repeat chest CT showed that the inflammatory disease in the right transplanted lung had significantly been reduced (Figure 3).

Figure 1 CT of the chest showed imaging changes consistent with interstitial pneumonia in the right lung graft. CT, computed tomography.
Figure 2 A CT scan of the chest 3 months before COVID-19 infection. CT, computed tomography; COVID-19, coronavirus disease 2019.
Figure 3 The inflammatory disease in the right transplanted lung was significantly reduced 1 month after treatment.

Acknowledgments

Funding: This study was supported by Guangdong Provincial Basic and Applied Basic Research Fund of China (No. 2020A1515110445); and the China State Key Laboratory of Respiratory Disease Independent Subject (No. SKLRD-QN-201925).

Footnote

Peer Review File: Available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1869/prf

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1869/coif). J.H. serves as the Executive Editor-in-Chief of Journal of Thoracic Disease. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee(s) and with the Helsinki Declaration (as revised in 2013). Written informed consent was obtained from the patient for publication of this article and accompanying images. A copy of the written consent is available for review by the editorial office of this journal.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Cite this article as: Zeng Y, Peng G, Yang C, Liu M, He J, Xu X. COVID-19 infection in a lung transplant recipient. J Thorac Dis 2024;16(4):2702-2703. doi: 10.21037/jtd-23-1869

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