COVID-19 pneumonia in lung transplant recipients: report of two cases

Coronavirus disease 2019 (COVID-19) has been declared pandemic since March 2020. In Europe, Italy has been the first nation affected by this infection. In this paper we report anamnestic data, clinical features and therapeutic management of two lung transplant recipients with confirmed COVID-19 pneumonia. Both patients were in good clinical conditions prior to the infection and were on immunosuppression with calcineurin inhibitors (CNI), mycophenolate mofetil and corticosteroids. Whilst mycophenolate mofetil was withdrawn in both cases, CNI were suspended only in the second patient. The first patient always maintained excellent oxygen saturation throughout hospitalization with no need for additional oxygen therapy. He was discharged with a satisfactory pulmonary function and a complete resolution of radiological and clinical findings. However, at discharge SARS-CoV-2 RNA could still be detected in the nasopharyngeal swab and in the stools. The second patient required mechanical ventilation, had a progressive deterioration of his clinical conditions and had a fatal outcome. Further insight into SARS-CoV-2 infection is eagerly awaited to improve the outcome transplant recipients affected by COVID-19 pneumonia.