Pulmonology · 2025
Risk of hospitalisation and mortality among patients with interstitial lung disease and COVID-19: A French multicentre prospective cohort.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Diesler Rémi, Gallay Laure, Uzunhan Yurdagül, Borie Raphaël, Reynaud-Gaubert Martine, Valentin Victor, Ahmad Kaïs, Lazor Romain, Wemeau Lidwine, Traclet Julie, Rigaud Pierre, Marchand-Adam Sylvain, Israël-Biet Dominique, Hirschi Sandrine, Bonniaud Philippe, Froidure Antoine, Montani David, Naccache Jean-Marc, Romain-Scelle Nicolas, Cottin Vincent, OrphaLung Network
Аннотация
INTRODUCTION AND OBJECTIVES: Risk factors of poor outcomes associated with COVID-19 are not well identified in patients with interstitial lung disease (ILD).
PATIENTS OR MATERIALS AND METHODS: We analysed a multicentre prospective cohort of patients with ILD and COVID-19 from January 2020 to December 2022. Risk factor analysis for death at 90 days and hospitalisation was conducted using logistic regression, adjusted for age and sex.
RESULTS: A total of 603 patients were included (66 years [54-74], 62% male). ILD diagnoses were autoimmune ILD (n = 147 [24%]), idiopathic pulmonary fibrosis (IPF, n = 124 [21%]), non-IPF fibrosing ILD (n = 118 [20%]), granulomatosis (n = 115 [19%]), exposure-related/secondary ILD (n = 68 [11%]), and other rare lung diseases (n = 31 [5%]). Hospitalisation due to COVID-19 was associated with cardiovascular disease, cancer or haematological disease, background glucocorticoid therapy, DLCO < 40%pred and FVC < 70%pred. Death due to COVID-19 at day 90 was associated with the underlying ILD diagnosis, background glucocorticoid therapy, cardiovascular disease, cancer or haematological disease, and DLCO < 40%pred, whereas vaccination against SARS-CoV-2 was protective. COVID-19-related mortality occurred mainly in the first 90 days after SARS-CoV-2 infection.
CONCLUSIONS: Poor outcomes related to COVID-19 are associated with ILD subtype and severity, background glucocorticoid therapy and absence of vaccination. There is no evidence of late mortality.
PATIENTS OR MATERIALS AND METHODS: We analysed a multicentre prospective cohort of patients with ILD and COVID-19 from January 2020 to December 2022. Risk factor analysis for death at 90 days and hospitalisation was conducted using logistic regression, adjusted for age and sex.
RESULTS: A total of 603 patients were included (66 years [54-74], 62% male). ILD diagnoses were autoimmune ILD (n = 147 [24%]), idiopathic pulmonary fibrosis (IPF, n = 124 [21%]), non-IPF fibrosing ILD (n = 118 [20%]), granulomatosis (n = 115 [19%]), exposure-related/secondary ILD (n = 68 [11%]), and other rare lung diseases (n = 31 [5%]). Hospitalisation due to COVID-19 was associated with cardiovascular disease, cancer or haematological disease, background glucocorticoid therapy, DLCO < 40%pred and FVC < 70%pred. Death due to COVID-19 at day 90 was associated with the underlying ILD diagnosis, background glucocorticoid therapy, cardiovascular disease, cancer or haematological disease, and DLCO < 40%pred, whereas vaccination against SARS-CoV-2 was protective. COVID-19-related mortality occurred mainly in the first 90 days after SARS-CoV-2 infection.
CONCLUSIONS: Poor outcomes related to COVID-19 are associated with ILD subtype and severity, background glucocorticoid therapy and absence of vaccination. There is no evidence of late mortality.