(181) A Single-Center Experience with More Than 200 Lung Transplant Recipients with COVID-19 Infection

PURPOSE: There still have been limited data regarding COVID-19 in lung transplant recipients (LTR). We sought the outcomes after COVID-19 infection in LTR using our largest dataset. METHODS: We analyzed our database of LTR who were diagnosed with COVID-19 between March 26, 2020 and September 6, 2022. First, we investigated the clinical outcomes of the all cohort, and then divided them into three groups depending on their time of diagnosis (Dx, 1st wave: 03/2020-10/2020, 2nd: 11/2020-11/2021, and 3rd: 12/2021-09/2022), and compared these results. RESULTS: 210 LTR (median age, 67; 67% male) were enrolled. The median time from LT to their Dx was 2.1 years. Five patients had the Dx during their index admission for LT whereas all of them died during their admission. One hundred forty patients (67%) required readmission, including 46 (33%) receiving ICU management. Among those hospitalized, 35 patients (25%) were intubated and 7 patients (5%) were placed on VV ECMO. Overall survival was 67% at 1 year and 59% at 2 years post-Dx (Figure 1). While 89 patients (42%) were unvaccinated at the time of their Dx, 121 patients (58%) were vaccinated including 63 patients (30%) with boosters. Although survival was significantly better in the 3rd period (Figure 1), hospital mortality has not changed (1st: 28%, 2nd: 38%, 3rd: 28%). Vaccination was the only significant predictor for hospital admission (initial series vs none: odds ratio [OR] 0.22; boosters vs none: OR 0.27). Age ≥ 70 years (OR 2.87) and initial series of vaccines (vs None: OR 3.10; vs boosters: OR 3.71) contribute to hospital mortality as an independent predictor. CONCLUSION: Survival post-COVID-19 infection in LTR continues to improve, however, hospital mortality remains remarkably high with 30%. Whereas vaccination appears to have been impactful in preventing hospital admission, vaccination also has demonstrated inconsistent results for reducing hospital mortality. Further research is continued focused on how to better identify the high risk LTR who may lead to the mortality.