Outcome of hospitalization for COVID-19 in patients with interstitial lung disease. An international multicenter study

Abstract

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; 1.39−3.71).

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.

Metadata

Item Type:	Article
Authors/Creators:	Drake, TM Docherty, AB Harrison, EM Quint, JK Adamali, H Agnew, S Babu, S Barber, CM Barratt, S Bendstrup, E Bianchi, S Villegas, DC Chaudhuri, N Chua, F Coker, R Chang, W Crawshaw, A Crowley, LE Dosanjh, D Fiddler, CA Forrest, IA George, PM Gibbons, MA Groom, K Haney, S Hart, SP Heiden, E Henry, M Ho, L-P Hoyles, RK Hutchinson, J Hurley, K Jones, M Jones, S Kokosi, M Kreuter, M MacKay, LS Mahendran, S Margaritopoulos, G Molina-Molina, M Molyneaux, PL O’Brien, A O’Reilly, K Packham, A Parfrey, H Poletti, V Porter, JC Renzoni, E Rivera-Ortega, P Russell, A-M Saini, G Spencer, LG Stella, GM Stone, H Sturney, S Thickett, D Thillai, M Wallis, T Ward, K Wells, AU West, A Wickremasinghe, M Woodhead, F Hearson, G Howard, L Baillie, JK Openshaw, PJM Semple, MG Stewart, I Jenkins, RG Baillie, JK Semple, MG Openshaw, PJM Carson, G Alex, B Bach, B Barclay, WS Bogaert, D Chand, M Cooke, GS Docherty, AB Dunning, J da Silva Filipe, A Fletcher, T Green, CA Harrison, EM Hiscox, JA Ho, AYW Horby, PW Ijaz, S Khoo, S Klenerman, P Law, A Lim, WS Mentzer, AJ Merson, L Meynert, AM Noursadeghi, M Moore, SC Palmarini, M Paxton, WA Pollakis, G Price, N Rambaut, A Robertson, DL Russell, CD Sancho-Shimizu, V Scott, JT de Silva, T Sigfrid, L Solomon, T Sriskandan, S Stuart, D Summers, C Tedder, RS Thomson, EC Thompson, AAR https://orcid.org/0000-0002-0717-4551 Thwaites, RS Turtle, LCW Zambon, M Hardwick, H Donohue, C Lyons, R Griffiths, F Oosthuyzen, W Norman, L Pius, R Drake, TM Fairfield, CJ Knight, S Mclean, KA Murphy, D Shaw, CA Dalton, J Girvan, M Saviciute, E Roberts, S Harrison, J Marsh, L Connor, M Halpin, S Jackson, C Gamble, C Leeming, G Law, A Wham, M Clohisey, S Hendry, R Scott-Brown, J Greenhalf, W Shaw, V McDonald, S Keating, S Ahmed, KA Armstrong, JA Ashworth, M Asiimwe, IG Bakshi, S Barlow, SL Booth, L Brennan, B Bullock, K Catterall, BWA Clark, JJ Clarke, EA Cole, S Cooper, L Cox, H Davis, C Dincarslan, O Dunn, C Dyer, P Elliott, A Evans, A Finch, L Fisher, LWS Foster, T Garcia-Dorival, I Greenhalf, W Gunning, P Hartley, C Ho, A Jensen, RL Jones, CB Jones, TR Khandaker, S King, K Kiy, RT Koukorava, C Lake, A Lant, S Latawiec, D Lavelle-Langham, L Lefteri, D Lett, L Livoti, LA Mancini, M McDonald, S McEvoy, L McLauchlan, J Metelmann, S Miah, NS Middleton, J Mitchell, J Moore, SC Murphy, EG Penrice-Randal, R Pilgrim, J Prince, T Reynolds, W Ridley, PM Sales, D Shaw, VE Shears, RK Small, B Subramaniam, KS Szemiel, A Taggart, A Tanianis-Hughes, J Thomas, J Trochu, E van Tonder, L Wilcock, E Zhang, JE Adeniji, K Agranoff, D Agwuh, K Ail, D Alegria, A Angus, B Ashish, A Atkinson, D Bari, S Barlow, G Barnass, S Barrett, N Bassford, C Baxter, D Beadsworth, M Bernatoniene, J Berridge, J Best, N Bothma, P Brealey, D Brittain-Long, R Bulteel, N Burden, T Burtenshaw, A Caruth, V Chadwick, D Chambler, D Chee, N Child, J Chukkambotla, S Clark, T Collini, P Cosgrove, C Cupitt, J Cutino-Moguel, M-T Dark, P Dawson, C Dervisevic, S Donnison, P Douthwaite, S DuRand, I Dushianthan, A Dyer, T Evans, C Eziefula, C Fegan, C Finn, A Fullerton, D Garg, S Garg, S Garg, A Gkrania-Klotsas, E Godden, J Goldsmith, A Graham, C Hardy, E Hartshorn, S Harvey, D Havalda, P Hawcutt, DB Hobrok, M Hodgson, L Holme, A Hormis, A Jacobs, M Jain, S Jennings, P Kaliappan, A Kasipandian, V Kegg, S Kelsey, M Kendall, J Kerrison, C Kerslake, I Koch, O Koduri, G Koshy, G Laha, S Laird, S Larkin, S Leiner, T Lillie, P Limb, J Linnett, V Little, J MacMahon, M MacNaughton, E Mankregod, R Masson, H Matovu, E McCullough, K McEwen, R Meda, M Mills, G Minton, J Mirfenderesky, M Mohandas, K Mok, Q Moon, J Moore, E Morgan, P Morris, C Mortimore, K Moses, S Mpenge, M Mulla, R Murphy, M Nagel, M Nagarajan, T Nelson, M Otahal, I Pais, M Panchatsharam, S Paraiso, H Patel, B Pepperell, J Peters, M Phull, M Pintus, S Pooni, JS Post, F Price, D Prout, R Rae, N Reschreiter, H Reynolds, T Richardson, N Roberts, M Roberts, D Rose, A Rousseau, G Ryan, B Saluja, T Shah, A Shanmuga, P Sharma, A Shawcross, A Sizer, J Shankar-Hari, M Smith, R Snelson, C Spittle, N Staines, N Stambach, T Stewart, R Subudhi, P Szakmany, T Tatham, K Thomas, J Thompson, C Thompson, R Tridente, A Tupper-Carey, D Twagira, M Ustianowski, A Vallotton, N Vincent-Smith, L Visuvanathan, S Vuylsteke, A Waddy, S Wake, R Walden, A Welters, I Whitehouse, T Whittaker, P Whittington, A Wijesinghe, M Williams, M Wilson, L Wilson, S Winchester, S Wiselka, M Wolverson, A Wooton, DG Workman, A Yates, B Young, P
Copyright, Publisher and Additional Information:	© 2020 by the American Thoracic Society. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
Keywords:	COVID-19; idiopathic pulmonary fibrosis; interstitial lung disease; obesity; lung function
Dates:	Published: 15 December 2020 Published (online): 2 October 2020 Accepted: 2 October 2020
Institution:	The University of Sheffield
Academic Units:	The University of Sheffield > Sheffield Teaching Hospitals
Funding Information:	Funder Grant number BRITISH HEART FOUNDATION FS/18/13/33281
Depositing User:	Symplectic Sheffield
Date Deposited:	12 May 2022 13:53
Last Modified:	12 May 2022 13:53
Status:	Published
Publisher:	American Thoracic Society
Refereed:	Yes
Identification Number:	10.1164/rccm.202007-2794oc
Related URLs:	Author
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:186765

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Outcome of hospitalization for COVID-19 in patients with interstitial lung disease. An international multicenter study

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