Becker's Clinical Quality & Infection Control

18 PATIENT SAFETY & OUTCOMES 1 in 10 US lung transplants are for COVID-19 patients By Gabrielle Masson C OVID-19 patients now account for about 1 in 10 U.S. lung transplants, according to data from the United Network for Organ Sharing, as cited by NPR. "If there were more lungs available for transplants, I believe the num- bers would be greater than they are," David Klassen, MD, chief medi- cal officer for UNOS, told NPR. In total, 238 U.S. COVID-19 patients have received lung transplants since tracking of the operations began in August 2020 through October, the most recent UNOS data available. Annually, more than 2,000 lung transplant operations are performed in the U.S. Lung transplants for COVID-19 patients in the U.S. rose tenfold be- tween the first year of the pandemic and 2021, according to UNOS data. Transplants for other lung diseases — such as emphysema, cystic fibrosis and pulmonary fibrosis — have de- clined compared to previous years. With vaccines now widely avail- able, the rise in COVID-19-related transplants has presented an ethical dilemma for some. Transplant cen- ters consider many factors when listing potential recipients, but social and behavioral factors, including vaccination status, aren't normally among them. Some transplant centers have taken patients off their lists if they aren't vaccinated, though some experts have said eliminating unvaccinated individuals from even being con- sidered for an organ may be unfair because it could exclude racial, religious or ethnic groups with lower vaccination rates. The American Society of Transplant Surgeons recommends that anyone awaiting a transplant get vaccinated against COVID-19. n Antidepressants may lower COVID-19 death risk, study suggests By Erica Carbajal P eople taking certain antidepressants, particularly fluoxetine, may have a lower death risk from COVID-19, according to research published Nov. 15 in JAMA Network Open. Researchers from the University of Califor- nia San Francisco and Stanford (Calif.) Uni- versity analyzed the EHRs of 83,584 patients diagnosed with COVID-19 from January to September 2020. Of those, 3,401 of the adult participants were prescribed selective serotonin reuptake inhibitors — a class of antidepressants. Participants were followed for as long as eight months. Compared to COVID-19 patients who weren't taking SSRIs, those taking fluoxe- tine, which goes by the name brand Prozac, were 28 percent less likely to die, findings showed. Participants taking either fluoex- tine or fluvoxamine, sold under the name Luvox, were 26 percent less likely to die. For patients taking any kind of SSRI, the mortality risk was reduced by 8 percent. "ese findings suggest that SSRIs, if proven effective, could be a therapeutic option to reduce mortality among patients with COVID-19," researchers said, adding that large clinical trials are needed to validate the findings. "e results are encouraging," said Tomiko Oskotsky, MD, study author and research scientist at UCSF. "It's important to find as many options as possible for treating any condition. A particular drug or treatment may not work or be well tolerated by everyone. Data from electronic medical records allow us to quickly look into existing drugs that could be repurposed for treating COVID-19 or other conditions." n New research may answer why people who are overweight face severe COVID-19 risk By Erica Carbajal T he coronavirus can directly infect fat cells, offering po- tential clues as to why people who are overweight and obese face higher risks of severe illness and death from COVID-19, according to research reported by The New York Times Dec. 8. Using fat tissue obtained from bar- iatric surgery patients, the research team, led by scientists from Stanford (Calif.) University School of Medi- cine, conducted experiments to see if the tissue could become infected. The researchers found that fat cells could be directly infected, and the infection triggered an inflammatory response associated with severe COVID-19. They also looked at fat tissue from the bodies of European patients who died from COVID-19 and found the virus in fat near vari- ous organs. The study was published in the preprint server bioRxiv in October. "The bottom line is, 'Oh my god, indeed, the virus can infect fat cells di- rectly,'" Philipp Scherer, PhD, a scientist who studies fat cells at UT Southwest- ern Medical Center in Dallas and who was not involved in the research, told the Times. "Whatever happens in fat doesn't stay in fat. It affects the neigh- boring tissues as well." Patients who are overweight and obese often have other accompany- ing health conditions such as diabetes that put them at higher risk of severe COVID-19, though these preliminary findings suggest obesity alone may be the reason some people are more vulnerable to serious illness. The study's authors also said the evidence may lead to new COVID-19 treatments that pinpoint body fat. n

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