TY - JOUR
T1 - Outcome of hospitalization for COVID-19 in patients with interstitial lung disease an international multicenter study
AU - ISARIC4C Investigators
AU - Drake, Thomas M.
AU - Docherty, Annemarie B.
AU - Harrison, Ewen M.
AU - Quint, Jennifer K.
AU - Adamali, Huzaifa
AU - Agnew, Sarah
AU - Babu, Suresh
AU - Barber, Christopher M.
AU - Barratt, Shaney
AU - Bendstrup, Elisabeth
AU - Bianchi, Stephen
AU - Villegas, Diego Castillo
AU - Chaudhuri, Nazia
AU - Chua, Felix
AU - Coker, Robina
AU - Chang, William
AU - Crawshaw, Anjali
AU - Crowley, Louise E.
AU - Dosanjh, Davinder
AU - Fiddler, Christine A.
AU - Forrest, Ian A.
AU - George, Peter M.
AU - Gibbons, Michael A.
AU - Groom, Katherine
AU - Haney, Sarah
AU - Hart, Simon P.
AU - Heiden, Emily
AU - Henry, Michael
AU - Ho, Ling Pei
AU - Hoyles, Rachel K.
AU - Hutchinson, John
AU - Hurley, Killian
AU - Jones, Mark
AU - Jones, Steve
AU - Kokosi, Maria
AU - Kreuter, Michael
AU - MacKay, Laura S.
AU - Mahendran, Siva
AU - Margaritopoulos, George
AU - Molina-Molina, Maria
AU - Molyneaux, Philip L.
AU - O'Brien, Aiden
AU - O'Reilly, Katherine
AU - Packham, Alice
AU - Parfrey, Helen
AU - Poletti, Venerino
AU - Porter, Joanna C.
AU - Renzoni, Elisabetta
AU - Fletcher, Tom
AU - Finch, Lorna
PY - 2020/12/15
Y1 - 2020/12/15
N2 - Rationale: The impact of coronavirus disease (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 the hospital with COVID-19 between March 1 and May 1, 2020, was undertaken and compared with patients without ILD, obtained from the ISARIC4C (International Severe Acute Respiratory and Emerging Infection Consortium Coronavirus Clinical Characterisation Consortium) cohort, admitted with COVID-19 over the same period. The primary outcome was survival. Secondary analysis distinguished idiopathic pulmonary fibrosis from non–idiopathic pulmonary fibrosis 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 the 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, patients with ILD with COVID-19 had significantly poorer survival (hazard ratio [HR], 1.60; confidence interval, 1.17–2.18; P = 0.003) than age-, sex-, and comorbidity-matched controls without ILD. Patients with an 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; 1.3923.71). 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.
AB - Rationale: The impact of coronavirus disease (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 the hospital with COVID-19 between March 1 and May 1, 2020, was undertaken and compared with patients without ILD, obtained from the ISARIC4C (International Severe Acute Respiratory and Emerging Infection Consortium Coronavirus Clinical Characterisation Consortium) cohort, admitted with COVID-19 over the same period. The primary outcome was survival. Secondary analysis distinguished idiopathic pulmonary fibrosis from non–idiopathic pulmonary fibrosis 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 the 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, patients with ILD with COVID-19 had significantly poorer survival (hazard ratio [HR], 1.60; confidence interval, 1.17–2.18; P = 0.003) than age-, sex-, and comorbidity-matched controls without ILD. Patients with an 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; 1.3923.71). 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.
KW - COVID-19
KW - Idiopathic pulmonary fibrosis
KW - Interstitial lung disease
KW - Lung function
KW - Obesity
U2 - 10.1164/rccm.202007-2794oc
DO - 10.1164/rccm.202007-2794oc
M3 - Article
SN - 1073-449X
VL - 202
SP - 1656
EP - 1665
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
IS - 12
ER -
SDG 3 Good Health and Well-being