[ISPHLT-OS2-3] 25-year-old female patient with a severe case of COVID-19 pneumonia who has undergone bilateral lung transplantation at adolescent age
[Introduction]COVID-19pneumonia is known to be severe in immunosuppressed organ transplant recipients. We report a severe clinical case in which a bilateral lung transplant recipient underwent tracheostomy and was receiving invasive mechanical ventilation due to COVID-19 pneumonia.[Case report]A 25-year-oldJapanese female bilateral lung transplant carrier at the 17 years old, came to the hospital with a fever and cough. She received a bilateral lung transplantation due to pulmonary arterial hypertension. She was taking tacrolimus and prednisone, and was also suffering from diabetes mellitus. She was hospitalized after testing COVID-19 positive undergoing nasopharyngeal PCR examination. On admission, she was in good general condition, had no respiratory distress and vital signs showed oxygen saturation 97% on room air. However, her respiratory condition gradually worsened, and was intubated and started invasive mechanical ventilation on the 7th day of admission. Anti-inflammatory and immunosuppressive therapy with intravenous methylprednisolone pulse and tocilizumab were administered, but it became difficult to discontinue the invasive mechanical ventilation due to serious lung damage. A tracheostomy was performed on the 49th day of admission. Although another lung transplantation is being considered, the patient is now aiming to wean off the mechanical ventilation while undergoing rehabilitation.[Summary]Although reports of COVID-19 pneumonia in organ transplant recipients are increasing, there are still only few reports on cases of lung transplantation recipients, especially lung transplant recipients at adolescent age. It is expected that more cases will accumulate in the future.