Clinics (Sao Paulo). 2020;75:e2274.

Early COVID-19 infection after lung transplantation in a patient with cystic fibrosis

Rodrigo Abensur Athanazio , André Nathan Costa , Rafael Medeiros Carraro , Diego Gonzalez , Samia Zahi Rached , Marcos Naoyuki Samano , Ricardo Henrique de Oliveira Braga Teixeira , Silvia Vidal Campos

DOI: 10.6061/clinics/2020/e2274

Since December 2019, when the initial cases of severe viral pneumonia caused by a new coronavirus were described, health services worldwide have sought to understand the evolution and risk factors related to the severity of coronavirus disease (COVID-19). Elderly individuals have been shown to be the highest risk group. However, other factors, such as male sex; obesity; smoking; and chronic heart, lung, kidney, and liver diseases, are also associated with a poor prognosis. We draw attention to immunosuppressed patients as they are a vulnerable group with a high susceptibility to severe forms of the disease (,). Clinical data on COVID-19 infection in a lung transplant population are still very limited. Herein, we report on a severe presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a 37-year-old male patient with cystic fibrosis (CF) in the second week after lung transplantation (LTx).

The patient was diagnosed as having CF at 7 months of age (homozygous F508del). Chronic airway infections included those caused by methicillin resistant Staphylococcus aureus, carbepenem-resistent Pseudomonas aeruginosa, and Aspergillus sp.. Because of his progressive respiratory insufficiency, bilateral LTx was performed in April 2020. The surgery was performed with 315 minutes of ischemic time, and there was no need for cardiopulmonary bypass. The donor was a 21-year-old man without comorbidities, without pulmonary infiltrates on chest computed tomography (CT), and with a negative SARS-CoV-2 nasopharyngeal swab polymerase chain reaction (PCR) who had developed encephalic death, confirmed 72 hours after a traumatic brain injury.

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