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In this study, the authors compared the outcomes of patients with interstitial lung disease (ILD) infected with COVID-19 with outcomes of COVID patients without ILD. They found that ILD patients with COVID-19 were at a higher risk of death than matched patients without ILD. Risk factors for death included male sex, FVC < 80% predicted, and obesity.
This is a helpful study to understand more about COVID-19 outcomes in patients with respiratory diseases such as ILD.
– Morgan Soffler, MD
This abstract is available on the publisher's site.
The impact of COVID-19 on patients with Interstitial Lung Disease (ILD) has not been established.
To assess outcomes in patients with ILD hospitalized for COVID-19 versus those without ILD in a contemporaneous age, sex and comorbidity matched population.
An international multicenter audit of patients with a prior diagnosis of ILD admitted to hospital with COVID-19 between 1 March and 1 May 2020 was undertaken and compared with patients, without ILD obtained from the ISARIC 4C cohort, admitted with COVID-19 over the same period. The primary outcome was survival. Secondary analysis distinguished IPF from non-IPF ILD and used lung function to determine the greatest risks of death.
MEASUREMENTS AND MAIN RESULTS
Data from 349 patients with ILD across Europe were included, of whom 161 were admitted to hospital with laboratory or clinical evidence of COVID-19 and eligible for propensity-score matching. Overall mortality was 49% (79/161) in patients with ILD with COVID-19. After matching ILD patients with COVID-19 had higher mortality (HR 1.60, Confidence Intervals 1.17-2.18 p=0.003) compared with age, sex and co-morbidity matched controls without ILD. Patients with a Forced Vital Capacity (FVC) of <80% had an increased risk of death versus patients with FVC ≥80% (HR 1.72, 1.05-2.83). Furthermore, obese patients with ILD had an elevated risk of death (HR 2.27, 1.39-3.71).
Patients with ILD are at increased risk of death from COVID-19, particularly those with poor lung function and obesity. Stringent precautions should be taken to avoid COVID-19 in patients with ILD. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
American Journal of Respiratory and Critical Care Medicine
Outcome of Hospitalization for COVID-19 in Patients With Interstitial Lung Disease: An International Multicenter Study
Am J Respir Crit Care Med 2020 Oct 02;[EPub Ahead of Print], TM Drake, AB Docherty, EM Harrison, JK Quint, H Adamali, S Agnew, S Babu, CM Barber, S Barratt, E Bendstrup, S Bianchi, D Castillo Villegas, N Chaudhuri, F Chua, R Coker, W Chang, A Cranshaw, LE Crowley, D Dosanjh, CA Fiddler, IA Forrest, PM George, MA Gibbons, K Groom, S Haney, SP Hart, E Heiden, M Henry, LP Ho, RK Hoyles, J Hutchinson, K Hurley, MG Jones, S Jones, M Kokosi, M Kreuter, LS Mackay, S Mahendran, G Margaritopoulos, M Molina-Molina, PL Molyneaux, A O'Brien, K O'Reilly, A Packham, H Parfrey, V Poletti, JC Porter, E Renzoni, P Rivera-Ortega, AM Russell, G Saini, LG Spencer, GM Stella, H Stone, S Sturney, D Thickett, M Thillai, T Wallis, K Ward, AU Wells, A West, M Wickremasinghe, F Woodhead, G Hearson, L Howard, JK Baillie, PJM Openshaw, MG Semple, I Stewart, RG Jenkins, ISARIC4C Investigators