COVID-19 has become a common infection affecting lung transplant recipients (LTR), who are at high risk for poor outcomes. Outcomes early in the pandemic were poor, but since the rollout of vaccination and novel COVID-19 treatments, outcomes of LTR have not been well described. Our aim was to evaluate the effect of COVID-19 on the clinical course and lung function trajectory in an Australian cohort of LTR. Data was retrospectively collected from LTR with confirmed COVID-19 managed at Alfred Health, between August 2020 and December 2022. Baseline demographics, COVID-19 disease details (including severity) and spirometry pre and post infection have been analysed. A total of 279 LTR were included. The cohort was comorbid, but well vaccinated, with 275/279 (98.6%) having 2 COVID-19 vaccines at symptom onset. Severe disease occurred in only 17 cases (6%) and overall mortality was very low (4%). Prompt treatment with antivirals, particularly remdesevir (OR 0.18, 95% CI 0.04-0.81, p=0.02] and vaccination (OR 0.24, CI 0.08-0.81, p=0.01] were protective. There was not a clinically significant drop in lung function post COVID-19 with the median absolute decline in forced expiratory volume (FEV1) being 40mL (IQR 5-120mL, p<0.001), with a decline of >10% occurring in only 42 patients (17%). After multivariate adjustment, only rejection prior to COVID-19 was significantly associated with FEV1 decline afterwards (OR 3.74, 1.12-11.86, p=0.03). In our highly COVID-19 vaccinated, promptly treated LTR, the majority of COVID-19 infections were mild and did not result in a clinically significant decline in lung function.

中文翻译：

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COVID-19 感染程度较轻，对接种良好且接受广泛治疗的肺移植受者的肺功能影响极小

COVID-19 已成为影响肺移植受者 (LTR) 的常见感染，他们的预后不良风险很高。大流行初期的结果很差，但自从疫苗接种和新的 COVID-19 治疗方法推出以来，LTR 的结果尚未得到很好的描述。我们的目的是评估 COVID-19 对澳大利亚 LTR 队列的临床病程和肺功能轨迹的影响。数据是在 2020 年 8 月至 2022 年 12 月期间从 Alfred Health 管理的 LTR 中回顾性收集的已确诊的 COVID-19。我们分析了感染前后的基线人口统计数据、COVID-19 疾病详细信息（包括严重程度）和肺活量测定。总共包括 279 LTR。该队列有共病，但疫苗接种情况良好，其中 275/279 (98.6%) 在症状出现时接种了 2 种 COVID-19 疫苗。仅 17 例（6%）出现严重疾病，总体死亡率非常低（4%）。及时使用抗病毒药物治疗，特别是瑞德塞韦（OR 0.18，95% CI 0.04-0.81，p=0.02）和疫苗接种（OR 0.24，CI 0.08-0.81，p=0.01）具有保护作用。肺功能没有临床上显着下降COVID-19 后，用力呼气量 (FEV1) 的中位绝对下降为 40mL（IQR 5-120mL，p<0.001），仅 42 名患者 (17%) 下降 >10%。多变量调整后，只有在 COVID-19 之前的拒绝与之后的 FEV1 下降显着相关（OR 3.74, 1.12-11.86, p=0.03）。在我们高度接种 COVID-19 疫苗并及时治疗的 LTR 中，大多数 COVID-19 感染都是轻微的，并且没有不会导致临床上显着的肺功能下降。