Predictors and outcomes of respiratory failure among lung transplant patients with COVID-19.
Clin Transplant
; 36(3): e14540, 2022 03.
Article
em En
| MEDLINE
| ID: mdl-34792221
ABSTRACT
BACKGROUND:
There is limited data on the predictors and outcomes of new or worsening respiratory failure among lung transplant (LT) patients with Coronavirus disease 2019 (COVID-19).METHODS:
We included all the LT patients diagnosed with COVID-19 during a 1-year period (March 2020 to February 2021; n = 54; median age 60, 20-73 years; MF 3717). Development of new or worsening respiratory failure (ARF) was the primary outcome variable.RESULTS:
The overall incidence of ARF was 48.1% (n = 26). More than 20% of patients (n = 11) needed intubation and mechanical ventilation. Body mass index > 25 Kg/m2 (adjusted OR 5.7, .99-32.93; P = .05) and peak D-dimer levels > .95 mcg/ml (adjusted OR 24.99, 1.77-353.8; P = .017) were independently associated with ARF while anticoagulation use prior to COVID-19 was protective (adjusted OR .024, .001-.55; P = .02). Majority patients survived the acute illness (85.2%). Pre-infection chronic lung allograft dysfunction (CLAD) was an independent predictor of mortality (adjusted HR 5.03, 1.14-22.25; P = .033).CONCLUSIONS:
COVID-19 is associated with significant morbidity and mortality among LT patients. Patients on chronic anticoagulation seem to enjoy favorable outcomes, while higher BMI and peak D-dimer levels are associated with development of ARF. Pre-infection CLAD is associated with an increased risk of death from COVID-19.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Insuficiência Respiratória
/
Transplante de Pulmão
/
COVID-19
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Clin Transplant
Assunto da revista:
TRANSPLANTE
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos