Abstract
Background Coronavirus disease 2019 (COVID-19) social distancing measures led to a dramatic decline in non-COVID-19 respiratory virus infections, providing a unique opportunity to study their impact on annual forced expiratory volume in 1 s (FEV1) decline, episodes of temporary drop in lung function (TDLF) suggestive of infection and chronic lung allograft dysfunction (CLAD) in lung transplant recipients (LTRs).
Methods All FEV1 values of LTRs transplanted between 2009 and April 2020 at the University Medical Center Groningen (Groningen, The Netherlands) were included. Annual FEV1 change was estimated with separate estimates for pre-social distancing (2009–2020) and the year with social distancing measures (2020–2021). Patients were grouped by individual TDLF frequency (frequent/infrequent). Respiratory virus circulation was derived from weekly hospital-wide respiratory virus infection rates. Effect modification by TDLF frequency and respiratory virus circulation was assessed. CLAD and TDLF rates were analysed over time.
Results 479 LTRs (12 775 FEV1 values) were included. Pre-social distancing annual change in FEV1 was −114 (95% CI −133– −94) mL, while during social distancing FEV1 did not decline: 5 (95% CI −38–48) mL (difference pre-social distancing versus during social distancing: p<0.001). The frequent TDLF subgroup showed faster annual FEV1 decline compared with the infrequent TDLF subgroup (−150 (95% CI −181– −120) versus −90 (95% CI −115– −65) mL; p=0.003). During social distancing, we found significantly lower odds for any TDLF (OR 0.53, 95% CI 0.33–0.85; p=0.008) and severe TDLF (OR 0.34, 0.16–0.71; p=0.005) as well as lower CLAD incidence (OR 0.53, 95% CI 0.27–1.02; p=0.060). Effect modification by respiratory virus circulation indicated a significant association between TDLF/CLAD and respiratory viruses.
Conclusions During COVID-19 social distancing the strong reduction in respiratory virus circulation coincided with markedly less FEV1 decline, fewer episodes of TDLF and possibly less CLAD. Effect modification by respiratory virus circulation suggests an important role for respiratory viruses in lung function decline in LTRs.
Abstract
Reduction in respiratory virus circulation during social distancing was associated with stabilisation of lung function in lung transplant recipients, suggesting a more important role for these infections in lung function decline than previously thought https://bit.ly/3tWuxDO
Footnotes
Conflict of interest: The authors declare no competing interests.
- Received January 12, 2022.
- Accepted June 18, 2022.
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