Incidence and severity of SARS-CoV-2 infection in lung transplant recipients in the Omicron era

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may cause serious illness in lung transplant recipients. We aimed to investigate incidence and severity of SARS-CoV-2 infection in lung transplant recipients in the Omicron era. We conducted a retrospective study investigating COVID-19 incidence and outcomes among lung transplant recipients between December 27, 2021, and October 31, 2022, in Denmark. We performed COX regression analysis of potential risk factors with hospitalization as an endpoint. Among 236 included patients, 108 had a first positive SARS-CoV-2 polymerase chain reaction during a total of 133 person-years of follow-up, resulting in an incidence rate of 813 per 1000 person-years (95% confidence intervals (CI) 670-977). The cumulative incidence of hospitalization was 24.1% (95% CI 26-32.1) and admission to the intensive care unit was 3.7% (95% CI 0.1-6.3). The 30-day mortality of recipients with a SARS-CoV-2 infection was 0.9% (95% CI 0-2.7). We found that the incidence rate of patients with SARS-CoV-2 infection was markedly higher, whereas the mortality rate was lower in the omicron era compared to earlier reports for lung transplant recipients conducted in the delta era. On the other hand, a substantial proportion of patients were hospitalized, suggesting a continuous impact on this patient population.