Infectious Disease

Mortality from COVID-19 was elevated in sufferers with pre-existing ILD

17th December 2020

1 min read

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Gallay does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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Mortality from COVID-19 was higher in patients with pre-existing fibrotic idiopathic interstitial lung disease than other interstitial lung diseases, researchers reported in a new study.

“Patients with pre-existing ILD may be at high risk for severe COVID-19 disease due to impaired lung function, a tendency to develop acute exacerbation of pulmonary fibrosis, or immunomodulatory drugs that may interact with viral clearance or pathogenesis,” Dr. Laure Gallay. of the National Coordinating Reference Center for Rare Lung Diseases at Claude Bernard University Lyon 1 in France, and colleagues wrote in the American Journal of Respiratory and Critical Care Medicine. “However, it is unknown whether the type of ILD can affect the outcome of COVID-19.”

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The researchers conducted a multicenter observational study in specialized centers to analyze survival rates in patients with COVID-19 and ILDs. The researchers reported data from 123 patients (mean age 64 years; 66% men) with COVID-19 and ILDs. The cases were collected from the start of the COVID-19 outbreak in France until May.

39% of patients had fibrotic idiopathic ILD, including idiopathic pulmonary fibrosis (n = 20), idiopathic nonspecific pneumonia (n = 8), and other fibrotic idiopathic ILDs (n = 20), the researchers reported. The other patients had connective tissue disease-associated ILD (n = 27), systemic vasculitis (n = 7), sarcoid (n = 16), and other ILDs (n = 25).

84 percent of the patients had to be hospitalized, 21 percent in intensive care units.

The primary outcome of the study was death 30 days after the COVID-19 infection. After 30 days, 35% of patients with fibrotic idiopathic ILD had died compared with 19% of patients with other ILDs (P = 0.04). The median time from diagnosis to death was 8 days, the researchers reported. Death was associated with COVID-19 infection in all cases, including four patients with an acute IPF exacerbation.

“Remarkably, the mortality in patients with an ILD other than the fibrotic ILD was comparable to that in the French world population hospitalized for COVID-19,” the researchers wrote.

In the univariate analysis and multivariate analysis, male gender (P = 0.03), older age (P <0.01), and chronic home oxygen supplement use (P <0.01) were independent predictors of mortality this patient study.

“The possible long-term effects of COVID-19 on the course of ILD have yet to be determined,” the researchers wrote.

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