Risk of COVID-19 infection with Interstitial Lung Disease
Interstitial lung disease ILD is a wide range of conditions, and the majority of them result in progressive scarring of lung tissue. This in turn limits the breathing capacity and the amount of oxygen in the bloodstream.
Long-term exposure to hazardous materials, such as asbestos, can induce ILD. It can also be caused by autoimmune disorders such as rheumatoid arthritis. However, the causes are unknown in certain circumstances.
Drake et al compared the in-hospital mortality rate of 161 ILD patients hospitalized with COVID-19 across different locations in Europe to a control group of COVID-19 patients without ILD, matched for age, sex, and non-pulmonary comorbidities. Patients with ILD had a considerably greater in-hospital mortality rate than those without ILD, (49 % vs. 35 %).
The risk of mortality was associated with the male gender and advancing age. For example, males 75 years of age had a mortality rate of 62%.inaddition, obesity, idiopathic pulmonary fibrosis, and forced vital capacity<80% were all linked to a higher risk of death.
Esposito et al. compared the mortality of 46 individuals with pre-existing ILD identified with COVID-19 to age, sex, and race-matched controls without ILD. the study has noted that individuals with ILD had a 33% mortality rate compared to 13% for controls. Patients with ILD had >4 fold higher than controls.
This study included both hospitalized and outpatient patients. Adult patients with ILD had an increased incidence of hospitalization (74% vs. 58%), ICU requirement (47% vs. 23%), and reduced chances for discharge.
Even after controlling for age, sex, and comorbidities, these two studies reveal that individuals with a wide variety of ILDs have a higher risk of death from COVID-19 than adults without ILD. The majority of the patients in both groups required hospitalization.
The implications of these findings for the management of patients with ILD during the COVID-19 epidemic are significant.
Both the studies indicate that patients with ILD are at higher risk of SARS-CoV-2 infection-related morbidity and mortality. The long-term impact of COVID-19 on patients with ILD remains undefined.