Clinical impacts of COVID-19 on severe exacerbation and mortality in interstitial lung disease: prognosis 30 days after infection

Background/Aims The impact of coronavirus disease 2019 (COVID-19) on severe exacerbation and mortality in interstitial lung disease (ILD) is unclear. In this study, we evaluate the risk of severe exacerbation and mortality in individuals with ILD following COVID-19. Methods Using the Korean National...

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Main Authors: Bo-Guen Kim, Sun-Kyung Lee, Dong Won Park, Tai Sun Park, Ji-Yong Moon, Tae-Hyung Kim, Sang-Heon Kim, Ho Joo Yoon, Hyun Lee
Format: Article
Language:English
Published: The Korean Association of Internal Medicine 2025-07-01
Series:The Korean Journal of Internal Medicine
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Online Access:http://kjim.org/upload/kjim-2024-388.pdf
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Summary:Background/Aims The impact of coronavirus disease 2019 (COVID-19) on severe exacerbation and mortality in interstitial lung disease (ILD) is unclear. In this study, we evaluate the risk of severe exacerbation and mortality in individuals with ILD following COVID-19. Methods Using the Korean National Health Insurance claim-based database, we compared the incidence and risk of severe exacerbation and mortality in individuals with ILD who survived at least one month after COVID-19 (COVID-19 cohort, n = 359) and 1:3 age, sex, and body mass index-matched individuals with ILD who did not have COVID-19 (controls, n = 1,077) between October 8, 2020, and August 30, 2021. Results During a mean follow-up of 7.4 months, the COVID-19 cohort had a higher risk of severe exacerbation compared to controls (aHR 2.26, 95% CI 1.38–3.69). During a mean follow-up of 19.6 months, the COVID-19 cohort had a higher risk of death (aHR 2.79, 95% CI 1.63–4.79) compared to controls. When considering COVID-19 severity, the severe COVID-19 group had a higher risk of severe exacerbation and death compared to controls, while the non-severe COVID-19 group did not show increased risk of severe exacerbation or death. In analyses based on ILD subtype, individuals with idiopathic pulmonary fibrosis in the COVID-19 cohort had the highest risk of severe exacerbation and death. Conclusions Previous severe COVID-19 was associated with worse clinical outcomes in individuals with ILD, especially in patients with idiopathic pulmonary fibrosis.
ISSN:1226-3303
2005-6648