SARS-CoV-2 infection in two patients following recent lung transplantation

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes Coronavirus disease 2019 (COVID-19) has become a world spreading health problem with pandemic character. Lung transplant recipients may be particularly at risk due to the high degree of immunosupression and the lung being the organ primarily affected by COVID-19. We describe a 16-year old male and a 64-year old female recently lung transplanted patients with COVID-19 during inpatient rehabilitation. Both patients were on triple immunosuppressive therapy and had no signs of allograft dysfunction. Both patients had close contact to a person who developed COVID-19 and were tested positive for SARS-CoV-2. Subsequently, both patients underwent systematic screening and SARS-CoV-2 was detected ultimately. While the 16-year old boy was completely asymptomatic, the 64-year old woman developed only mild COVID-19. Immunosuppressive therapy was unchanged and no experimental treatment was initiated. No signs of graft involvement or dysfunction were noticed. In conclusion, our report of patients with asymptomatic SARS-CoV-2 infection and mild COVID-19 respectively, may indicate that lung transplant recipients are not per se at risk for severe COVID-19. Further observations and controlled trials are urgently needed to study SARS-CoV-2 infection in lung transplant recipients.