Key result
Systemic corticosteroids show no link to FEV1 recovery after respiratory viral infections in lung transplant recipients.
Why the study?
Respiratory viral infections in lung transplant recipients have been associated with rejection and chronic lung allograft dysfunction, but evidence for systemic corticosteroid treatment is limited.
Does systemic corticosteroid use improve lung function recovery in adult lung transplant recipients with outpatient respiratory viral infections?
Cohort (n=100)
No
Does systemic corticosteroid use improve lung function recovery in adult lung transplant recipients with outpatient respiratory viral infections?
Systemic corticosteroid treatment was not associated with improved lung function recovery in lung transplant recipients with outpatient respiratory viral infections.
Corticosteroids should not yet change practice for outpatient viral infections post-lung transplant; hypothesis-generating and requires prospective randomized confirmation.
INTRODUCTION: Respiratory viral infections (RVI) in lung transplant recipients (LTR) have variably been associated with rejection and chronic lung allograft dysfunction. Our center has used systemic corticosteroids to treat outpatient RVI in some cases, but evidence is limited. We reviewed all adult LTR diagnosed with outpatient RVI January 2017 to December 2019. The primary outcome was recovery of lung function (forced expiratory volume in 1 s [FEV1]) at next stable visit between 1 and 12 months postinfection, expressed as a ratio over stable preinfection FEV1 (FEV1 recovery ratio). METHODS: We identified 100 adult LTR with outpatient RVI diagnoses eligible for study, 36% of whom received corticosteroids. We modelled the adjusted association between corticosteroid use and FEV1 recovery ratio using linear regression. RESULTS: Steroid-treated patients had a lower FEV1 presentation ratio (0.92 vs. 1.04, p = .0070) and were more likely to have chronic lung allograft dysfunction at time of infection (25% vs. 5%, p = .0077). Mean FEV1 recovery ratio was 1.02 (SD 0.19) with no association with corticosteroid therapy via multivariable linear regression (p = .5888). CONCLUSIONS: Steroid treatment was not associated with FEV1 recovery. This suggests corticosteroids may not have a role in the management of RVI in this population.
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Li et al. (2023) conducted a cohort in Outpatient respiratory viral infections in lung transplant recipients (n=100). Systemic corticosteroids vs. No systemic corticosteroids was evaluated on Recovery of lung function (FEV1 recovery ratio) at next stable visit between 1 and 12 months postinfection (p=0.5888). Systemic corticosteroid treatment for outpatient respiratory viral infections in lung transplant recipients was not associated with FEV1 recovery (p=0.5888).
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