Patients with preexisting fibrotic idiopathic interstitial lung disease (ILD) had a higher rate of mortality related to coronavirus disease 2019 (COVID-19) compared with patients with other ILDs, according to study results published in the American Journal of Respiratory and Critical Care Medicine.
Patients with preexisting ILD may be at high risk for severe COVID-19; however, whether the type of ILD may influence the outcome of COVID-19 is unknown. Therefore, researchers compared the mortality of COVID-19 between patients with fibrotic idiopathic ILD, including idiopathic pulmonary fibrosis (IPF) to those with other types of ILD through a multicentric observational survey of specialized centers in France.
A total of 123 patients were included, of whom 48 (39%) had fibrotic idiopathic ILD including IPF (n=20), idiopathic nonspecific pneumonia (n=8), and other fibrotic idiopathic ILDs (n=20). Hospital admission was required in 84% of patients (90% with fibrotic idiopathic ILD and 80% with other ILDs), including 21% in intensive care units. At day 30 of COVID-19, 35% of patients with fibrotic idiopathic ILD had died compared with 19% of those with other ILDs (P =.04). The median time between diagnosis and death was 8 days; death was related to COVID-19 in all cases, including 4 in whom COVID-19 triggered an acute exacerbation of IPF.
“In conclusion, this study found a high mortality rate due to COVID-19 in patients with preexisting fibrotic idiopathic ILD as compared to those with other ILDs, which was mostly attributable to age, male sex, history of cancer, and severity of the underlying ILD as reflected by the chronic use of supplemental oxygen supplementation,” the study authors wrote. “The potential long-term impact of COVID-19 on the course of ILD remains to be determined.”
Gallay L, Uzunhan Y, Borie R, et al, on behalf of the OrphaLung Network. Risk factors for mortality following COVID-19 in patients with pre-existing interstitial lung disease. Am J Respir Crit Care Med. Published online November 30, 2020. doi:10.1164/rccm.202007-2638LE