(1703) COVID-19 and Lung Transplant: A Deadly Combination

Introduction: Lung transplant remains one of the key treatment modalities in patients with chronic lung disease. One of the most significant pathologies in this subset of the patient population is COVID-19. This study aims to compare the factors associated with the development of COVID-19 and mortality in post-lung transplant patients.

Methods: This is a cross-sectional study based on National Inpatient Sample 2020 comparing key variables in patients who developed COVID-19 after lung transplant compared to patients who did not develop COVID-19 at a tertiary care center in Houston, Texas. The variables under study include Age; Gender; Race; Length of stay; Insurance; Region of hospital; Location (urban vs rural) and significant comorbidities. The same variables are also compared between patients who expired in the post-transplant period and those who remained alive during this time period.

Results: A total of 67 patients developed COVID-19 after lung transplant while 2442 patients did not. Additionally, 84 patients expired in the post-transplant period (which included 9 COVID-19 patients) while 2425 patients remained alive. The study showed no significant difference in Age; Gender; Length of stay; Among patients who expired, length of stay greater than 14 days, hospital location in the North East and South, and certain comorbid conditions (Congestive heart failure, Cerebrovascular disease, and non-metastatic cancer) along with a CCI score of more than 4 were significantly higher than in patients who remained alive. Patients with COVID-19 were almost 9 times more likely to die compared to patients without COVID-19 (OR: 8.9; p-value < 0.0001).

Conclusions: The study reveals a few factors that stand out in terms of their association with the development of COVID-19 and mortality in post-lung transplant patients. However, higher mortality in hospitals in the North East region and Native Americans was surprising and not expected. Moreover, certain severe comorbid conditions were not associated with the development of COVID-19 or mortality including COPD, renal disease, Diabetes mellitus with complications, and others which was an interesting finding. The main limitation of the study was the small sample size of COVID-19 patients.