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Introduction. Shared characteristics between COVID-19 and pulmonary fibrosis, including symptoms, genetic architecture, and circulating biomarkers, suggests interstitial lung disease (ILD) development may be associated with SARS-CoV-2 infection. Methods. The UKILD Post-COVID study planned interim analysis was designed to stratify risk groups and estimate the prevalence of Post-COVID Interstitial Lung Damage (ILDam) using the Post-HOSPitalisation COVID-19 (PHOSP-COVID) Study. Demographics, radiological patterns and missing data were assessed descriptively. Bayes binomial regression was used to estimate the risk ratio of persistent lung damage >10% involvement in linked, clinically indicated CT scans. Indexing thresholds of percent predicted DLco, chest X-ray findings and severity of admission were used to generate risk strata. Number of cases within strata were used to estimate the amount of suspected Post-COVID ILDam. Results. A total 3702 people were included in the UKILD interim cohort, 2406 completed an early follow-up research visit within 240 days of discharge and 1296 had follow-up through routine clinical review. We linked the cohort to 87 clinically indicated CTs with visually scored radiological patterns (median 119 days; interquartile range 83 to 155, max 240), of which 74 people had ILDam. ILDam was associated with abnormal chest X-ray (RR 1.21 95%CrI 1.05; 1.40), percent predicted DLco<80% (RR 1.25 95%CrI 1.00; 1.56) and severe admission (RR 1.27 95%CrI 1.07; 1.55). A risk index based on these features suggested 6.9% of the interim cohort had moderate to very-high risk of Post-COVID ILDam. Comparable radiological patterns were observed in repeat scans >90 days in a subset of participants. Conclusion. These interim data highlight that ILDam was not uncommon in clinically indicated thoracic CT up to 8 months following SARS-CoV-2 hospitalisation. Whether the ILDam will progress to ILD is currently unknown, however health services should radiologically and physiologically monitor individuals who have Post-COVID ILDam risk factors.

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Introduction and ObjectivesChronic Obstructive Pulmonary Disease (COPD) is characterised by expiratory flow limitation contributing to dyspnoea and impacting on exercise capacity and quality of life. Inspiratory muscle training is commonly used to improve inspiratory muscle strength and endurance, exercise capacity and quality of life. The High Frequency Airway Oscillating (HFAO) device uses flow resistance to provide combined inspiratory and expiratory muscle training. It is hypothesised that the use of a HFAO device may improve the strength of the respiratory muscles resulting in reduced sensation of dyspnoea. This study was designed to explore the feasibility of HFAO in COPD.MethodsPatients with symptomatic COPD were included (MRC of ≥3). This was a single arm feasibility study using a HFAO device. All participants used the device for 5 min, 3 times per day, for eight-weeks. The primary outcomes were recruitment, attrition and compliance. Self-reported daily diaries identified participants as adherent if they completed ≥75% of device use. Secondary outcome measures included maximal inspiratory and expiratory pressures (Pimax/Pemax), Incremental and Endurance Shuttle Walking Tests (ISWT/ESWT) and health related quality of life questionnaires. Data was analysed by a Wilcoxon Signed Rank test and considered statistically significant if p<0.05.Results23 participants with COPD were recruited (65% male, mean [SD] age 65[5] years, FEV1%predicted 44[16], FEV1/FVC ratio 0.46 [0.13]), median [IQR] MRC 4 [3–5], of which 20 participants completed the intervention. 62% of potential participants were recruited and there was an attrition rate of 13%. 90% of participants were considered adherent to device use. A significant improvement in MRC score (median change −1 [IQR 3–3]) was observed (p≥0.01). Significant improvements were seen in Pimax and Pemax (table 1). Pre and post intervention exercise performance and quality of life are shown in Table 1.Abstract P72 Table 1n= 20PrePostP value MRC4 [3–5]3 [3–3]>0.01PImax (cm H2O)59 [34–74]63 [42–85]0.04PEmax (cm H2O)102 [62–125]110 [97–137]>0.01ISWT (m)200 [140–260]240 [170–270]0.68ESWT (secs)170.5 [131–247]203 [142–274]0.51CRQ dyspnoea2.6 [2–3]2.5 [2–4]0.32LCQ total15.71 [13–19]21.5 [16–26]0.14HADS Anxiety6 [3–10]6 [3–11]0.24HADS Depression6 [4–10]5 [4–7]0.19LCADL total32 [28–45]29 [23–39]0.26CAT Total24[18–29]21.5 [16–26]0.14CAT Sputum3[2–4]3 [2–4]0.76Median [IQR] and p-value.MRC, Medical Research Council dyspnoea score, PImax, Maximal Inspiratory Pressure; PEmax, Maximal Expiratory Pressure; ISWT, Incremental Shuttle Walking Test; ESWT, Endurance Shuttle Walking Test; CRQ, Chronic Respiratory Questionnaire; LCQ, Leicester Cough Questionnaire; HADS, Hospital Anxiety and Depression Score; LCADL, London Activity of Daily Living, CAT COPD Assessment Test.ConclusionsThis shows promising Results in the use of HFAO to reduce dyspnoea within COPD. Recruitment and attrition was appropriate and compliance rates were considered suitable and therefore it is feasible to proceed to a randomi...