{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:32:55Z","timestamp":1753893175918,"version":"3.41.2"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Transplant."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Respiratory viruses can impact the allograft function in lung transplant recipients, but it is unknown if this occurs with SARS-CoV-2 infection. We studied the long-term outcomes of lung transplant recipients infected with SARS-CoV-2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single-center retrospective study compared lung transplant recipients with SARS-CoV-2 between June 2020 and April 2021 with a matched control group. Within the SARS-CoV-2 cohort, univariable associations between clinical factors and outcomes were tested. Changes in pulmonary function tests were analyzed. Primary endpoints included acute cellular rejection and all-cause mortality within 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty-three lung transplant recipients were infected with SARS-CoV-2. The median age was 64 years. 29 (54.7%) were managed outpatient, and 24 (45.3%) required hospitalization, with 13 intensive care unit admissions. All-cause mortality was 24.5%. Within the SARS-CoV-2 cohort, older age was significantly associated with all-cause mortality (<jats:italic>p<\/jats:italic>-value 0.017) as was ICU admission (<jats:italic>p<\/jats:italic>\u2009=\u20090.009) and an A1C\u2009&amp;gt;\u20096.5 (<jats:italic>p<\/jats:italic>\u2009=\u20090.033). The mean change in FEV1 was \u22121.1% at 3 months with minimal change at 6 and 12 months (\u22122.6% and \u22121% respectively), all compared to baseline. Acute cellular rejection was identified in 13.7% of the SARS-CoV-2 cohort compared to 11.8% in the matched control group; it was not significantly associated with the infection status (<jats:italic>p<\/jats:italic>\u2009=\u20090.706). However, all-cause mortality was significantly associated with infection status (<jats:italic>p<\/jats:italic>\u2009=\u20090.019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Long-term outcomes of SARS-CoV-2 in lung transplant recipients are widely variable. Within the SARS-CoV-2 cohort, all-cause mortality was 24.5%, and older age was significantly associated with mortality. We did not observe significant declines in FEV1 in this group.<\/jats:p><\/jats:sec>","DOI":"10.3389\/frtra.2025.1583919","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T05:25:38Z","timestamp":1747805138000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes of a case-control lung transplant cohort after SARS-CoV-2 infection"],"prefix":"10.3389","volume":"4","author":[{"given":"Sandrine","family":"Hanna","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rami","family":"Hallak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna 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