Outcome of Hospitalization for COVID-19 in Patients with Interstitial Lung Disease An International Multicenter Study
Por:
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, LP, 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, AM, 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
Publicada:
15 dic 2020
Resumen:
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.
Filiaciones:
Drake, TM:
Univ Edinburgh, Ctr Med Informat, Usher Inst, Edinburgh, Scotland
Docherty, AB:
Univ Edinburgh, Ctr Med Informat, Usher Inst, Edinburgh, Scotland
Harrison, EM:
Univ Edinburgh, Ctr Med Informat, Usher Inst, Edinburgh, Scotland
Quint, JK:
Imperial Coll, Natl Heart & Lung Inst, London, England
Adamali, H:
North Bristol NHS Trust, Bristol Interstitial Lung Dis Serv, Bristol, Avon, England
Univ Bristol, Southmead Hosp, Acad Resp Unit, Bristol, Avon, England
Agnew, S:
Liverpool Univ Hosp NHS Fdn Trust, Liverpool Interstitial Lung Dis Serv, Aintree Site, Liverpool, Merseyside, England
Babu, S:
Queen Alexandra Hosp, Portsmouth, Hants, England
Barber, CM:
Northern Gen Hosp, Sheffield, S Yorkshire, England
Barratt, S:
North Bristol NHS Trust, Bristol Interstitial Lung Dis Serv, Bristol, Avon, England
Univ Bristol, Southmead Hosp, Acad Resp Unit, Bristol, Avon, England
Bendstrup, E:
Aarhus Univ Hosp, Ctr Rare Lung Dis, Dept Resp Dis & Allergy, Aarhus, Denmark
Bianchi, S:
Northern Gen Hosp, Sheffield, S Yorkshire, England
Villegas, DC:
Hosp Holy Cross & St Paul, Interstitial Lung Dis ILD Unit, Resp Med Dept, Barcelona, Spain
Chaudhuri, N:
Manchester Univ Hosp NHS Fdn Trust, Wythenshawe Hosp, ILD Unit, Wythenshawe, England
Univ Manchester, Manchester, Lancs, England
Chua, F:
Royal Brompton & Harefield NHS Fdn Trust, London, England
Coker, R:
Imperial Coll Healthcare NHS Trust, Hammersmith Hosp, Resp Med, London, England
Chang, W:
Nottingham Univ Hosp NHS Trust, Nottingham, England
Crawshaw, A:
Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp Birmingham, Birmingham Interstitial Lung Dis Unit, Birmingham, W Midlands, England
Crowley, LE:
Univ Birmingham, Birmingham, W Midlands, England
Dosanjh, D:
Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp Birmingham, Birmingham Interstitial Lung Dis Unit, Birmingham, W Midlands, England
Fiddler, CA:
Royal Papworth Hosp NHS Fdn Trust, Cambridge Interstitial Lung Dis Serv, Cambridge, England
Forrest, IA:
Newcastle Upon Tyne Hosp NHS Fdn Trust, Royal Victoria Infirm, Dept Resp Med, Newcastle Upon Tyne, Tyne & Wear, England
George, PM:
Imperial Coll, Natl Heart & Lung Inst, London, England
Royal Brompton & Harefield NHS Fdn Trust, London, England
Gibbons, MA:
Royal Devon & Exeter Fdn NHS Trust, South West Peninsula ILD Network, Exeter, Devon, England
Groom, K:
Imperial Coll Healthcare NHS Trust, Hammersmith Hosp, Resp Med, London, England
Haney, S:
Northumbria Healthcare NHS Fdn Trust, Northumbria Specialist Emergency Care Hosp, Cramlington, England
Hart, SP:
Castle Hill Hosp, Hull York Med Sch, Resp Res Grp, Cottingham, England
Heiden, E:
Univ Hosp Southampton NHS Fdn Trust, Southampton, Hants, England
Henry, M:
Cork Univ Hosp, Cork, Ireland
Ho, LP:
Oxford Univ Hosp NHS Fdn Trust, Oxford Interstitial Lung Dis Serv, Oxford, England
Hoyles, RK:
Oxford Univ Hosp NHS Fdn Trust, Oxford Interstitial Lung Dis Serv, Oxford, England
Hutchinson, J:
Kings Mill Hosp, Sutton In Ashfield, Notts, England
Hurley, K:
Royal Coll Surgeons Ireland, Dept Med, Dublin, Ireland
Beaumont Hosp, Dublin, Ireland
Jones, M:
Univ Hosp Southampton NHS Fdn Trust, Southampton, Hants, England
Univ Southampton, Natl Inst Hlth Res NIHR Southampton Biomed Res Ct, Southampton, Hants, England
Univ Southampton, Clin & Expt Sci, Southampton, Hants, England
Jones, S:
Act Pulm Fibrosis, Stuart House, Peterborough, Cambs, England
Kokosi, M:
Royal Brompton & Harefield NHS Fdn Trust, London, England
Guys & St Thomas NHS Trust, London, England
Kreuter, M:
Heidelberg Univ, Ctr Interstitial & Rare Lung Dis, Thoraxklin, Pneumol, Heidelberg, Germany
German Ctr Lung Res, Heidelberg, Germany
MacKay, LS:
Northumbria Healthcare NHS Fdn Trust, Northumbria Specialist Emergency Care Hosp, Cramlington, England
Mahendran, S:
Kingston Hosp NHS Fdn Trust, Kingston Upon Thames, Surrey, England
Margaritopoulos, G:
Manchester Univ Hosp NHS Fdn Trust, Wythenshawe Hosp, ILD Unit, Wythenshawe, England
Molina-Molina, M:
Univ Hosp Bellvitge, ILD Unit, Inst Invest Biomed Bellvitge, Resp Dept, Barcelona, Spain
Molyneaux, PL:
Imperial Coll, Natl Heart & Lung Inst, London, England
O'Brien, A:
Univ Hosp Limerick, Limerick, Ireland
O'Reilly, K:
Mater Misericordiae Univ Hosp, Dept Resp Med, Dublin, Ireland
Packham, A:
Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp Birmingham, Birmingham Interstitial Lung Dis Unit, Birmingham, W Midlands, England
Parfrey, H:
Royal Papworth Hosp NHS Fdn Trust, Cambridge Interstitial Lung Dis Serv, Cambridge, England
Poletti, V:
Aarhus Univ Hosp, Ctr Rare Lung Dis, Dept Resp Dis & Allergy, Aarhus, Denmark
Morgagni Hosp, Dept Dis Thorax, Forli, Italy
Porter, JC:
UCL, UCL Resp, London, England
Univ Coll London Hosp NHS Fdn Trust, ILD Serv, London, England
Renzoni, E:
Royal Brompton & Harefield NHS Fdn Trust, London, England
Rivera-Ortega, P:
Manchester Univ Hosp NHS Fdn Trust, Wythenshawe Hosp, ILD Unit, Wythenshawe, England
Russell, AM:
Imperial Coll, Natl Heart & Lung Inst, London, England
St Marys Hosp, Imperial Healthcare NHS Trust, London, England
Saini, G:
Nottingham Univ Hosp NHS Trust, Nottingham, England
Spencer, LG:
Liverpool Univ Hosp NHS Fdn Trust, Liverpool Interstitial Lung Dis Serv, Aintree Site, Liverpool, Merseyside, England
Stella, GM:
Fdn Ist Ricovero & Cura Carattere Sci, Pneumol Unit, Lab Biochem & Genet, Policlin San Matteo, Pavia, Italy
Stone, H:
Univ Hosp North Midlands NHS Trust, Royal Stoke Univ Hosp, Stoke On Trent, Staffs, England
Sturney, S:
Royal United Hosp Bath NHS Fdn Trust, Bath, Avon, England
Thickett, D:
Univ Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp Birmingham, Birmingham Interstitial Lung Dis Unit, Birmingham, W Midlands, England
Univ Birmingham, Birmingham, W Midlands, England
Thillai, M:
Royal Papworth Hosp NHS Fdn Trust, Cambridge Interstitial Lung Dis Serv, Cambridge, England
Wallis, T:
Univ Hosp Southampton NHS Fdn Trust, Southampton, Hants, England
Univ Southampton, Natl Inst Hlth Res NIHR Southampton Biomed Res Ct, Southampton, Hants, England
Univ Southampton, Clin & Expt Sci, Southampton, Hants, England
Ward, K:
Imperial Coll, Natl Heart & Lung Inst, London, England
Wells, AU:
Royal Brompton & Harefield NHS Fdn Trust, London, England
West, A:
Guys & St Thomas NHS Trust, London, England
Wickremasinghe, M:
St Marys Hosp, Imperial Healthcare NHS Trust, London, England
Woodhead, F:
Glenfield Hosp, Inst Lung Hlth, Interstitial Lung Dis Unit, Leicester, Leics, England
Hearson, G:
Univ Nottingham, NIHR Biomed Res Ctr, Resp Res Unit, Nottingham, England
Howard, L:
Univ Nottingham, NIHR Biomed Res Ctr, Resp Res Unit, Nottingham, England
Baillie, JK:
Univ Edinburgh, Roslin Inst, Edinburgh, Scotland
Royal Infirm Edinburgh NHS Trust, Intens Care Unit, Edinburgh, Scotland
Openshaw, PJM:
Imperial Coll, Natl Heart & Lung Inst, London, England
Semple, MG:
Univ Liverpool, Fac Hlth & Life Sci, Inst Infect Vet & Ecol Sci, NIHR Hlth Protect Res Unit Emerging & Zoonot Infe, Liverpool, Merseyside, England
Alder Hey Childrens Hosp, Resp Med, Liverpool, Merseyside, England
Stewart, I:
Univ Nottingham, NIHR Biomed Res Ctr, Resp Res Unit, Nottingham, England
Jenkins, RG:
Nottingham Univ Hosp NHS Trust, Nottingham, England
Univ Nottingham, NIHR Biomed Res Ctr, Resp Res Unit, Nottingham, England
Green Published, Green Accepted, hybrid
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