{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:43:25Z","timestamp":1753879405131,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous reports of coronavirus disease 2019 (COVID\u201019) following lung transplantation generally described a grim prognosis, but these were anecdotal case series of symptomatic patients. A systematic study of the outcomes and pathology of SARS\u2010CoV\u20102 infection in a large cohort of lung transplant patients is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To determine the histopathologic evolution of COVID\u201019 in lung transplant recipients, we identified all patients who underwent surveillance transbronchial biopsies at our institution, tested positive for SARS\u2010CoV\u20102, and had multiple pathology specimens available for evaluation. Histology was reviewed and immunofluorescence for SARS\u2010CoV\u20102 nucleocapsid protein was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten patients met inclusion criteria. Half (5\/10) had incidental diagnosis on routine respiratory pathogen testing at the time of transbronchial biopsy. Six patients were hospitalized, with three requiring intensive care unit (ICU) admission. One patient died. Two specimens showed new onset International Society for Heart and Lung Transplantation (ISHLT) Grade A2 rejection at or following diagnosis. One patient developed bronchiolitis obliterans 111\u00a0days following diagnosis and 1\u00a0year post transplant. Two patients had organizing pneumonia at diagnosis and three patients showed evolving lung injury following diagnosis. The SARS\u2010CoV\u20102 nucleocapsid protein was detected in a subset of samples at diagnosis and up to 111\u00a0days following diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, the pathology of SARS\u2010CoV\u20102 infection in lung transplant patients is varied, ranging from no pathologic alterations to organizing pneumonia and lung injury. The pathology findings did not necessarily correlate with clinical acuity, as one patient admitted to the ICU had normal pathology. These findings may be generalizable to non\u2010transplant patients and require more follow\u2010up regarding long\u2010term outcomes.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid13823-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13823","type":"journal-article","created":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T23:49:05Z","timestamp":1647128945000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evolution of pathological findings in surveillance biopsies of lung transplant recipients infected with SARS\u2010CoV\u20102"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8813-3523","authenticated-orcid":false,"given":"Alexander N.","family":"Wein","sequence":"first","affiliation":[{"name":"Department of Pathology and Immunology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4269-3234","authenticated-orcid":false,"given":"Chieh\u2010Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15998"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003339"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15941"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13356"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16241"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14534"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30243-5"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2020.02.010"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30076-X"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqaa062"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-020-02975-6"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.5603\/ARM.a2021.0032"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000514822"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.6002\/ect.2020.0563"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13480"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.01.443"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb2104756"}],"container-title":["Transplant 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Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13823","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.13823","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13823","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T20:08:23Z","timestamp":1692562103000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.13823"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,21]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1111\/tid.13823"],"URL":"https:\/\/doi.org\/10.1111\/tid.13823","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"type":"print","value":"1398-2273"},{"type":"electronic","value":"1399-3062"}],"subject":[],"published":{"date-parts":[[2022,3,21]]},"assertion":[{"value":"2021-11-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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