Evidence map›Paper›PMID 40957936›Full record

ArticleNature communications2025

SARS-CoV-2 infection dynamics in a MHCI-mismatched lung transplant recipient.

Jonas Fuchs, Vivien Karl, Ina Hettich, Jaime Alvarado, Daniel Eckert, Lena Jaki, Ann-Kathrin Kohl, Anastasia Kremser, Anastasija Maks, Charlott Terschluse and 24 more

Abstract readCase Reports
In one paragraph

Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors.

Jonas Fuchs *Institute of Virology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0003-1974-212X
Vivien Karl *Faculty of Biology, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0001-7026-7622
Ina Hettich *Department of Pneumology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Jaime AlvaradoDepartment of Pneumology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0001-6634-8024
Daniel EckertDepartment of Medicine II, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Lena JakiInstitute of Virology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0001-9732-181X
Ann-Kathrin KohlInstitute of Virology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Anastasia KremserFaculty of Biology, University of Freiburg, Freiburg, Germany.
Anastasija MaksInstitute of Virology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Charlott TerschluseDepartment of Pneumology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Prerana AgarwalDepartment of Radiology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Florian EmmerichInstitute for Transfusion Medicine and Gene Therapy, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Sebastian FähndrichDepartment of Pneumology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Annabelle FlüglerInterdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Daniel HornussDivision of Infectious Diseases, Dept. Med. II, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0002-2621-3341
Johannes KalbhennDepartment of Anaesthesiology and Critical Care Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Nikolaus KneidingerDepartment of Internal Medicine, Division of Respiratory Medicine, Lung Research Cluster, Medical University of Graz, Graz, Austria.
Inga LauDepartment of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0009-0005-3725-2732
Achim LotherInterdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Isabelle MonekeDepartment of Thoracic Surgery, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany.
David SchibilskyDepartment of Cardiovascular Surgery, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Elisabeth SchygullaInstitute for Surgical Pathology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Nils VenhoffDepartment of Rheumatology and Clinical Immunology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0001-7729-2759
Gernot ZisselDepartment of Pneumology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0001-8021-9798
Martin CzernyDepartment of Cardiovascular Surgery, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Daniela HuzlyInstitute of Virology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Georg KochsInstitute of Virology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0003-0187-559X
Christoph Neumann-HaefelinDepartment of Medicine II, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0001-7351-1387
Bernward PasslickDepartment of Thoracic Surgery, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany.
Daiana StolzDepartment of Pneumology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Robert ThimmeDepartment of Medicine II, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID http://orcid.org/0000-0003-1417-4135
Marcus PanningInstitute of Virology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. marcus.panning@uniklinik-freiburg.de.ORCID http://orcid.org/0000-0003-3596-5964
Maike HofmannDepartment of Medicine II, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. maike.hofmann@uniklinik-freiburg.de.ORCID http://orcid.org/0000-0001-8410-8833
Björn C FryeDepartment of Pneumology, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. bjoern.christian.frye@uniklinik-freiburg.de.ORCID http://orcid.org/0000-0003-3520-1868

Funding

Deutsche Forschungsgemeinschaft (German Research Foundation) HO-5836/2-1Helmholtz Association KA1-Co-02 "COVIPA
6 · The paper itself

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.

Indexed as

COVID-19Lung TransplantationSARS-CoV-2Antibodies, ViralAntiviral AgentsHLA AntigensHumansImmunosuppressive AgentsLungMaleMiddle AgedTransplant RecipientsAntibodies, ViralAntiviral AgentsHLA AntigensImmunosuppressive Agents

Identifiers

PMID40957936
PMCPMC12441153

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.