New research indicates that baseline lung health is a stronger predictor of SARS-CoV-2 outcomes in cystic fibrosis transplantation patients than the time elapsed since transplantation.

By Roli Omamuli


RT’s Three Key Takeaways:

  1. Baseline Lung Function: Higher baseline lung health, measured by predicted percentage forced expiratory volume in one second (ppFEV1), was associated with a lower likelihood of severe COVID-19 outcomes.
  2. Transplant Timing: The interval between a patient’s transplant procedure and SARS-CoV-2 infection did not significantly influence the odds of hospitalization or death.
  3. Clinical Monitoring: While lung function remained stable for many patients post-infection, individuals with advanced disease require vigilant monitoring, preventive care, and consistent follow-up.


Interval time between lung transplant and COVID-19 infection in cystic fibrosis patients did not significantly affect hospitalization or mortality, according to data published in The Journal of Cystic Fibrosis.

Researchers compiled data from 526 cystic fibrosis transplant recipients across 19 countries who contracted SARS-CoV-2. The median age of participants was 36 years, and the median time since transplant was almost six years. Hospitalization or death following infection was the primary measure of severity, while changes in lung function over the year after infection were assessed as a secondary outcome.

The study found that the interval since transplantation did not significantly influence the odds of hospitalization or death. Statistical analysis showed an odds ratio close to 1, indicating no meaningful impact of transplant timing on outcomes from SARS-CoV-2 infection. Conversely, higher baseline lung function, measured by predicted percentage forced expiratory volume in one second (ppFEV1), was linked to a lower likelihood of severe outcomes. In a subgroup analysis, lung function trajectory did not change significantly over the year following SARS-CoV-2 infection. However, patients with more advanced lung disease remain at increased risk and require close monitoring.

These findings highlight the importance of baseline lung assessment in managing cystic fibrosis transplant recipients during the pandemic. While timing of transplant appears less critical than lung health, individuals with lower ppFEV1 should continue to receive vigilant monitoring and preventive care to reduce the risk of severe complications from SARS-CoV-2. The findings suggest that post-infection lung function may remain stable in some patients and could help inform follow-up strategies and patient counseling.

However, most participants were several years past their transplant, with a median time of 5.8 years (interquartile range 3.3–10.8). Additional research is needed to assess COVID-19 outcomes in patients who are closer to their transplantation date, as risk profiles could differ in the early post-transplant period.


Reference

Semenchuk J et al. Outcomes of SARS-CoV-2 infection post-solid organ transplantation in the cystic fibrosis population. J Cyst Fibros. 2026;DOI:10.1016/j.jcf.2026.02.009

This article was originally published by EMJ and was made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.