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...

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.

Citation

Drake, T. M., Docherty, A. B., Harrison, E. M., Quint, J. K., Adamali, H., Agnew, S., Babu, S., Barber, C. M., Barratt, S., Bendstrup, E., Bianchi, S., Castillo Villegas, D., Chaudhuri, N., Chua, F., Coker, R., Chang, W., Cranshaw, A., Crowley, L. E., Dosanjh, D., Fiddler, C. A., …ISARIC4C Investigators. (2020). Outcome of Hospitalization for COVID-19 in Patients with Interstitial Lung Disease: An International Multicenter Study. American Journal of Respiratory and Critical Care Medicine, 202(12), 1656–1665. https://doi.org/10.1164/rccm.202007-2794oc

• 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