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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; Bianchi, Stephen; Castillo Villegas, Diego; Chaudhuri, Nazia; Chua, Felix; Coker, Robina; Chang, William; Cranshaw, Anjali; Crowley, Louise E.; Dosanjh, Davinder; Fiddler, Christine A; Forrest, Ian A.; George, Peter M; Gibbons, Michael A; Groom, Katherine; Haney, Sarah; Hart, Simon P; Heiden, Emily; Henry, Michael; Ho, Ling-Pei; Hoyles, Rachel K; Hutchinson, John; Hurley, Killian; Jones, Mark G; Jones, Steve; Kokosi, Maria; Kreuter, Michael; Mackay, Laura S; Mahendran, Siva; Margaritopoulos, George; Molina-Molina, Maria; Molyneaux, Philip L; O'Brien, Aidan; O'Reilly, Katherine; Packham, Alice; Parfrey, Helen; Poletti, Venerino; Porter, Joanna C.; Renzoni, Elisabetta; Rivera-Ortega, Pilar; Russell, Anne-Marie; Saini, Gauri; Spencer, Lisa G; Stella, Giulia M.; Stone, Helen; Sturney, Sharon; Thickett, David...

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Authors

Thomas M Drake

Annemarie B Docherty

Ewen M Harrison

Jennifer K Quint

Huzaifa Adamali

Sarah Agnew

Suresh Babu

Christopher M Barber

Shaney Barratt

Elisabeth Bendstrup

Stephen Bianchi

Diego Castillo Villegas

Nazia Chaudhuri

Felix Chua

Robina Coker

William Chang

Anjali Cranshaw

Louise E. Crowley

Davinder Dosanjh

Christine A Fiddler

Ian A. Forrest

Peter M George

Michael A Gibbons

Katherine Groom

Sarah Haney

Simon P Hart

Emily Heiden

Michael Henry

Ling-Pei Ho

Rachel K Hoyles

John Hutchinson

Killian Hurley

Mark G Jones

Steve Jones

Maria Kokosi

Michael Kreuter

Laura S Mackay

Siva Mahendran

George Margaritopoulos

Maria Molina-Molina

Philip L Molyneaux

Aidan O'Brien

Katherine O'Reilly

Alice Packham

Helen Parfrey

Venerino Poletti

Joanna C. Porter

Elisabetta Renzoni

Pilar Rivera-Ortega

Anne-Marie Russell

Gauri Saini

Lisa G Spencer

Giulia M. Stella

Helen Stone

Sharon Sturney

David Thickett

Muhunthan Thillai

Tim Wallis

Katie Ward

Athol U Wells

Alex West

Melissa Wickremasinghe

Felix Woodhead

Glenn Hearson

Lucy Howard

J. Kenneth Baillie

Peter J M Openshaw

Malcolm G Semple

Iain Stewart

R Gisli Jenkins

ISARIC4C Investigators



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 [less than]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.

Journal Article Type Article
Acceptance Date Oct 2, 2020
Online Publication Date Oct 2, 2020
Publication Date Dec 15, 2020
Deposit Date Oct 7, 2020
Publicly Available Date Oct 3, 2021
Journal American Journal of Respiratory and Critical Care Medicine
Print ISSN 1073-449X
Electronic ISSN 1535-4970
Publisher American Thoracic Society
Peer Reviewed Peer Reviewed
Volume 202
Issue 12
Pages 1656–1665
DOI https://doi.org/10.1164/rccm.202007-2794oc
Keywords Critical Care and Intensive Care Medicine; Pulmonary and Respiratory Medicine
Public URL https://nottingham-repository.worktribe.com/output/4939383
Publisher URL https://www.atsjournals.org/doi/10.1164/rccm.202007-2794OC

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