Greenville area woman becomes first UNC patient to undergo a double lung transplant after severe case of COVID-19

Since the start of the pandemic, countless people have lost their lives to COVID-19. Tolishia Alexander was almost one of them. On Aug. 10, 2021, she became the first UNC patient to undergo a double lung transplant due to COVID-19.

She and husband Warren Alexander were married on April 24, 2021. In late May, COVID-19 spread through their new blended family. Everyone experienced relatively mild symptoms, except for the new bride.

She was hospitalized at Vidant Hospital in Greenville, but her case required escalating levels of care, In late July, Alexander was airlifted to UNC Hospitals in Chapel Hill for their lung transplant program.

A good health history gave her a fighting chance, according to Dr. Benjamin Haithcock, UNC’s surgical director of the lung transplant program. “She had previously been healthy. She had not had any other major medical problems or any other surgical issues,” said Haithcock.

He says many patients who develop severe symptoms of COVID-19 come with a variety of health issues like being overweight, being of advanced age or living with others who have chronic health problems.

Haithcock says it’s difficult to determine which patients are going to respond well to treatment versus those who will require longer term or more invasive care. He said, “That’s the biggest health headache that we have right now with our COVID pandemic."

Alexander was a good candidate for special support with a heart-lung-bypass machine called ECMO paired with a system called VV or "veno-venous ECMO”. In that approach, special cannulas are placed in a large neck vein to draw blood out through one channel and back in through another.

It can help physicians determine if the lungs will recover or if the patient would be a good candidate for lung transplantation. The approach relieved pressure on Alexander’s lungs so she could breathe and get up to walk. “And it actually allowed her to get stronger in preparation for lung transplant,” said Haithcock.

“So it was an awesome feat for the entire team to be able to get her to progress on to the transplant,” said Haithcock.

Then a set of donated lungs gave Alexander a chance to get her life back, the way it was before COVID-19, as a mother, a dental assistant and newlywed.

According to a JAMA article in June 2021, 134 COVID-19 patients in the U.S. had received lung transplants.