Characteristics and outcomes among lung transplant patients with respiratory syncytial virus infection

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Abstract

Background: To describe characteristics and outcomes among lung transplantation (LT) patients with respiratory syncytial virus (RSV) infection and elucidate the predictors of 1-year survival after RSV infection. Methods: This was a retrospective chart review study among LT patients with RSV infection between 2013 and 2018 (90 episodes among 87 patients; mean age 56.3 ± 13.1 years, M:F 52:35). A contemporaneous control group consisting of LT patients without RSV infection (n = 183) was included. One-year survival after the RSV infection was the primary endpoint. Results: Median time from LT to RSV infection was 30 (1-155) months. Before RSV infection, the median decline in forced vital capacity (FVC) was 9.7 cc (−17.8 to 83 cc) or 0.29% (−1.4% to 4.6%) per month, while the forced expiratory volume (FEV1) decline was 7.5 cc (−8.8 to 58 cc) or 0.3% (−0.57% to 4.3%) per month with no statistically significant change after RSV infection. One-year survival among patients with RSV infection was 86.2% (75/87). Pre-infection diagnosis of chronic lung allograft dysfunction (CLAD; adjusted HR: 4.29, 1.08-17.0; P =.038) and FVC or FEV1 decline >10% during 6 months post infection (adjusted HR: 35.1, 3.26-377.1; P =.003) were independently associated with worse survival. On propensity score matched analysis, RSV infection was not associated with worse post-transplant survival (HR with 95% CI: 0.79, 0.47-1.34; P =.38). Conclusions: A majority of LT patients in the current cohort did not experience an alteration in the trajectory of FVC or FEV1 decline after developing RSV infection, and their post-transplant survival was not adversely impacted. Established CLAD at the time of RSV infection and post infection >10% decline in FVC or FEV1 are independently associated with worse survival after RSV infection.

Original languageEnglish (US)
JournalTransplant Infectious Disease
DOIs
StateAccepted/In press - 2021

Keywords

  • chronic lung allograft dysfunction
  • community-acquired respiratory virus infections
  • multiplex PCR
  • predictors

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation

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