Outcome of Hospitalization for COVID-19 in Patients with Interstitial Lung Disease: An International Multicenter Study.



Drake, Thomas M, Docherty, Annemarie B, Harrison, Ewen M, Quint, Jennifer K, Adamali, Huzaifa, Agnew, Sarah, Babu, Suresh, Barber, Christopher M, Barratt, Shaney, Bendstrup, Elisabeth
et al (show 61 more authors) (2020) Outcome of Hospitalization for COVID-19 in Patients with Interstitial Lung Disease: An International Multicenter Study. Am J Respir Crit Care Med.

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Abstract

RATIONALE: The impact of COVID-19 on patients with Interstitial Lung Disease (ILD) has not been established. OBJECTIVES: To assess outcomes in patients with ILD hospitalized for COVID-19 versus those without ILD in a contemporaneous age, sex and comorbidity matched population. METHODS: 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). CONCLUSIONS: 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/).

Item Type: Article
Uncontrolled Keywords: COVID-19, IPF, ILD, Obesity, Lung Function, hospitalisation
Depositing User: Symplectic Admin
Date Deposited: 09 Oct 2020 08:09
Last Modified: 23 Sep 2021 10:58
DOI: 10.1164/rccm.202007-2794OC
Open Access URL: https://doi.org/10.1164/rccm.202007-2794OC
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3103908