Prior SARS‐CoV‐2 infection may not alter the clinical course of COVID‐19 in lung transplant recipients: A single‐center experience

AbstractBackgroundIn the general population, prior infection with SARS‐CoV‐2 reduces the risk of severe COVID‐19; however, studies in lung transplant recipients (LTRs) are lacking. We sought to describe the clinical course of COVID‐19 recurrence and compare outcomes between the first and second episodes of COVID‐19 in LTRs.MethodsWe conducted a retrospective, single‐center cohort study of LTRs with COVID‐19 between January 1, 2022, and September 30, 2022, during the Omicron wave. We compared the clinical course of a second episode of COVID‐19 to that of the patients’ own first episode and to that of LTRs who developed a first episode during the study period.ResultsDuring the study period, we identified 24 LTRs with COVID‐19 recurrence and another 75 LTRs with a first episode of COVID‐19. LTRs who survived the initial episode of COVID‐19 had a similar disease course with recurrence, with a trend toward reduced hospitalization (10 (41.6%) vs. 4 (16.7%), p = .114). Furthermore, compared to LTRs with a primary infection during the Omicron wave, those with a reinfection had a non‐statistically significant trend toward reduced hospitalizations (aOR .391, 95% CI [.115–1.321], p = .131), shorter lengths‐of‐stay (median, 4 vs. 9 days, p = .181), and reduced intensive care unit admissions, intubations, and COVID‐19–related mortality.ConclusionsLTRs who survive the first episode of COVID‐19 are likely to have a similar clinical course with recurrent episodes. Although recurrent COVID‐19 may be milder, larger, well‐powered studies are needed to confirm this observation. Ongoing precautions are warranted.