TY - JOUR
T1 - Outcome of Hospitalization for COVID-19 in Patients with Interstitial Lung Disease
T2 - 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 - Castillo Villegas, Diego
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 G
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, Aidan
AU - O'Reilly, Katherine
AU - Packham, Alice
AU - Parfrey, Helen
AU - Poletti, Venerino
AU - Porter, Joanna C
AU - Renzoni, Elisabetta
AU - Rivera-Ortega, Pilar
AU - Baillie, J Kenneth
PY - 2020/12/15
Y1 - 2020/12/15
N2 - 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/).
AB - 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/).
U2 - 10.1164/rccm.202007-2794OC
DO - 10.1164/rccm.202007-2794OC
M3 - Article
C2 - 33007173
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 -
