Selected Publication:

SHR Neuro Cancer Cardio Lipid Metab Microb

Fuchs, J; Karl, V; Hettich, I; Alvarado, J; Eckert, D; Jaki, L; Kohl, AK; Kremser, A; Maks, A; Terschluse, C; Agarwal, P; Emmerich, F; Fähndrich, S; Flügler, A; Hornuss, D; Kalbhenn, J; Kneidinger, N; Lau, I; Lother, A; Moneke, I; Schibilsky, D; Schygulla, E; Venhoff, N; Zissel, G; Czerny, M; Huzly, D; Kochs, G; Neumann-Haefelin, C; Passlick, B; Stolz, D; Thimme, R; Panning, M; Hofmann, M; Frye, BC.
SARS-CoV-2 infection dynamics in a MHCI-mismatched lung transplant recipient
NAT COMMUN. 2025; 16(1): 8292 Doi: 10.1038/s41467-025-63681-y
Web of Science PubMed FullText FullText_MUG

 

Co-authors Med Uni Graz

Kneidinger Nikolaus

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Abstract:

A 48-year-old patient underwent lung transplantation because of severe COVID-19, which aggravated his underlying interstitial lung disease, despite the presence of detectable SARS-CoV-2. Subsequently, the graft is re-infected early in the post-procedural phase, leading to viral persistence for more than five months. By analyzing viral evolution and effector immune response within the transplanted organ, we observe three main findings. First, virus evolution differs in the transplanted organ compared to that in the upper respiratory tract and is affected by monoclonal SARS-CoV-2-specific antibodies and molnupiravir. Second, we show the potential clinical relevance of T cell HLA restriction that may facilitate viral clearance in the upper respiratory tract compared to the ongoing viral replication in the HLA mismatch organ. Third, close monitoring and modulation of immunosuppressive and antiviral therapy enables viral clearance in a lung transplantation setting despite incomplete SARS-CoV-2 clearance prior to transplantation.

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