Effect of RSV Infection on Lung Function in Transplant Patients

Respiratory Syncytial Virus, RSV
Respiratory Syncytial Virus, RSV
Patients with established chronic lung allograft dysfunction may have a higher risk for respiratory syncytial virus infections, but lung function decline does not appear to be significantly affected.

This article is part of Pulmonology Advisor‘s coverage of the CHEST 2019 meeting, taking place in New Orleans, LA. Our staff will report on medical research related to asthma, COPD, critical care medicine, and more conducted by experts in the field. Check back regularly for more news from CHEST 2019.


NEW ORLEANS — Patients with established chronic lung allograft dysfunction (CLAD) may have a higher risk for respiratory syncytial virus (RSV) infections, but lung function decline does not appear to be significantly affected, according to the results of a retrospective study presented at the CHEST Annual Meeting held from October 19 to 23, in New Orleans, Louisiana.

Researchers sought to determine the effect of RSV infection on lung function in people who received lung transplants for up to 1 year after the infection. They queried electronic medical records for a diagnosis of RSV among patients with lung transplantation from 2013 to 2017. A total of 90 episodes of RSV infection occurred among 87 patients (mean age, 56.3±13.1 years) and complete data were available for 77 episodes among 75 patients. Established CLAD preceded 28 episodes of RSV (31.1%).

The average rate of forced vital capacity (FVC) decline was 1.35% per month before RSV infection and the forced expiratory volume in 1 second (FEV1) decline was 1.17% per month. After RSV infection, the rate of FVC and FEV1 decline tended to slow, although there were no statistically significant changes in the decline rates. However, in terms of individual episodes, the rate of decline did appear to accelerate for FVC after 35.1% of the episodes, after 33.8% of the episodes for FEV1, and after approximately a quarter of the episodes for both FVC and FEV1.

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“While RSV was associated with significant all-cause mortality at one year, mortality attributable to progressive CLAD was seen among <10% of the patients,” the researchers wrote. “Furthermore, RSV did not alter the average rate of lung function decline for the group.”

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Reference

Mahan L, Lill I, Wiggins A, et al. Impact of respiratory syncytial virus infections on lung functions among patients with lung transplantation. Presented at: CHEST Annual Meeting 2019; October 19-23, 2019; New Orleans, LA. Abstract 1637.