**5. Conclusions**

We confirmed and expanded on the results from previous studies of COVID-19 infections in LTRs. The mortality from COVID-19 remained high in the LTR population despite the use of newer modalities of therapy. A higher FEV1 at baseline with a difference of at least 100 mL was shown to protect against hospitalization. Breakthrough COVID-19 infections are common in vaccinated LTRs and can result in severe disease. Additional studies are needed to determine the optimal vaccination strategies in the LTR population. Risk mitigation strategies including social distancing and masking during periods of high transmission, and prompt diagnosis and treatment are important. The long-term effects of COVID-19 on lung allografts remain unknown.

**Supplementary Materials:** The following supporting information can be downloaded at: https: //www.mdpi.com/article/10.3390/transplantology3030026/s1, Table S1: Baseline characteristics of lung transplant recipients with COVID-19 based on level of care; Table S2: Characteristics of 59 lung transplant recipients with symptomatic COVID-19.

**Author Contributions:** D.J.F.-P., M.L., M.G.F. and G.A. designed the study. D.J.F.-P. and M.G.F. collected the data. D.J.F.-P. wrote the manuscript draft. M.L. analyzed the data and performed the statistical analysis. D.J.F.-P., M.G.F., M.L. and G.A. critically revised the manuscript for important intellectual content. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

**Institutional Review Board Statement:** The study was conducted in accordance with the Declaration of Helsinki and approved by the Henry Ford Health System Institutional Review Board (protocol code 14948 approved on 24 June 2021).

**Informed Consent Statement:** Patient consent was waived due to minimal risk.

**Data Availability Statement:** Available upon request.

**Acknowledgments:** We thank Stephanie Stebens, MLIS, AHIP, Sladen Library, for her contribution in helping to edit the manuscript.

**Conflicts of Interest:** The authors declare no conflict of interest.
