Patients with idiopathic pulmonary fibrosis have poor clinical outcomes with COVID-19 disease: a propensity matched multicentre research network analysis

被引:24
作者
Naqvi, Syeda Fatima [1 ]
Lakhani, Dhairya A. [2 ]
Sohail, Amir Humza [3 ]
Maurer, James [3 ]
Sofka, Sarah [4 ]
Sarwari, Arif [5 ]
Hadi, Yousaf B. [6 ]
机构
[1] West Virginia Univ, Dept Med, Sect Pulm & Crit Care Med, Morgantown, WV 26506 USA
[2] West Virginia Univ, Radiol, Morgantown, WV 26506 USA
[3] NYU Langone Hlth, Gen Surg, New York, NY USA
[4] West Virginia Univ, Internal Med, Morgantown, WV 26506 USA
[5] West Virginia Univ, Dept Med, Sect Infect Dis, Morgantown, WV 26506 USA
[6] West Virginia Univ, Dept Med, Morgantown, WV 26506 USA
关键词
COVID-19; interstitial fibrosis; viral infection;
D O I
10.1136/bmjresp-2021-000969
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Introduction Outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with pre-existing idiopathic pulmonary fibrosis (IPF) remain understudied, and it is unknown if IPF is an independent predictor of worse disease course. Herein, we report the clinical outcomes in a large cohort of 251 patients with COVID-19 in the setting of known IPF. Outcomes were compared with a propensity matched cohort of patients with COVID-19 without IPF. Methods Analysis of a federated multicentre research network TriNetX was performed including patients more than 16 years of age diagnosed with SARS-CoV-2 infection. Outcomes in patients diagnosed as positive for SARS-CoV-2 infection with concurrent IPF were compared with a propensity matched cohort of patients without IPF. Results A total of 311 060 patients with SARS-CoV-2 infection on the research network were identified, 251 patients (0.08%) carried a diagnosis of IPF. Mean age of patients with IPF was 68.30 +/- 12.20 years, with male predominance (n=143, 56.97%). Comorbidities including chronic lower respiratory diseases, diabetes mellitus, ischaemic heart disease and chronic kidney disease were more common in patients with IPF when compared with the non-IPF cohort. After propensity matching, higher rates of composite primary outcome (death or mechanical ventilation) at 30 and 60 days, as well as need for hospitalisation, critical care, and acute kidney injury were observed in the IPF cohort. Conclusion Poor outcomes of COVID-19 disease were observed in patients with IPF after robust matching of confounders. Our data confirm that patients with IPF constitute a high-risk cohort for poor outcomes related to COVID-19 disease.
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