SARS-CoV-2 infection in lung transplant recipients: a single-center retrospective study in Japan

Lung transplant (LTx) recipients are at a higher risk of infection and mortality due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The course of coronavirus disease 2019 (COVID-19) in Japanese LTx recipients remains unknown. This study aimed to clarify the incidence, outcomes, and clinical characteristics of COVID-19 in LTx recipients in Japan over a 3-year period.

This single-center retrospective study enrolled all LTx recipients who underwent LTx at Kyoto University Hospital between June 2008 and December 2022 and who were followed up during the COVID-19 pandemic from March 2020 to June 2023.

Among 230 LTx recipients, 64 (27.8%) developed SARS-CoV-2 infection and one (1.6%) died due to COVID-19. No significant differences in baseline characteristics, except for hypertension, were observed between the LTx recipients with and without COVID-19. Disease severity decreased as variants of concern transitioned but remained high even after 2022. Unilateral LTx, advanced age, and diabetes mellitus were associated with COVID-19 severity.

The incidence of COVID-19 in LTx recipients was similar to that in the general Japanese population, whereas the disease severity in LTx recipients remained high even after the Omicron era. Continuous development of preventive and early therapeutic interventions is required for these vulnerable groups.