Patients with idiopathic pulmonary fibrosis (IPF) have an increased risk of complications following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, commonly known as coronavirus disease 2019 (COVID-19). The authors of a study published in BMJ Open Respiratory Research concluded, “patients with IPF constitute a high-risk cohort for poor outcomes related to COVID-19 disease.”

Naqvi et al found overall mortality rates in patients with IPF of 15.94% within 30 days of infection and 18.33% within 60 days. In addition, 44.22% of the patients in the IPF group required hospitalization and 21.91% were admitted to critical care units. Out of the 251 IPF patients diagnosed with COVID-19, 29 (11.55%) required mechanical ventilation and 65 (25.90%) suffered from acute renal failure.

After propensity score matching, the rates of mortality, hospitalization, critical care admission, and need for mechanical ventilation of non-IPF patients were 11%, 24.70%, 7.97%, and 5.18%, respectively.

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Treating Patients With IPF in the Age of COVID-19

A deeper look into the subgroup of hospitalized IPF patients showed a mortality rate of about 30%, which was consistent with previous studies. Out of the 111 hospitalized IPF patients, 47 (42.34%) needed critical care and 19 (17.12%) required mechanical ventilation.

Patients aged more than 16 years at the time of COVID-19 diagnosis were selected from the TriNetX platform, a federated research network that includes more than 40 healthcare organizations in the USA. This retrospective study included 251 patients with IPF, both hospitalized and nonhospitalized, and 310,809 non-IPF individuals. Comorbidities were more prevalent in the IPF group and included chronic lower respiratory diseases, diabetes mellitus, ischemic heart disease, and chronic kidney disease.

Given the results in this study, Naqvi et al recommended considering patients with IPF in preventive efforts, such as vaccination.

Reference

Naqvi SF, Lakhani DA, Sohail AH, et al. Patients with idiopathic pulmonary fibrosis have poor clinical outcomes with COVID-19 disease: a propensity matched multicentre research network analysis. BMJ Open Respir Res. 2021;8(1):e000969. doi:10.1136/bmjresp-2021-000969

COVID-19