COVID-19 and acute exacerbation of interstitial lung disease

Abstract

We conducted a study to examine the effect of COVID-19 on the acute exacerbation of interstitial lung disease (AE-ILD) early in the COVID-19 epidemic (January 1–April 30, 2020). An online questionnaire survey was conducted, which was completed by 134 hospitals. During this period, 854 patients with AE-ILD (including 12 cases of COVID-AE-idiopathic pulmonary fibrosis were hospitalized at 128 hospitals. In comparison, the total number of AE-ILD hospitalizations during the same period in 2019 was 894. The number of hospitalizations increased at 17 hospitals, decreased at 27, and remained the same at 88 hospitals in 2020 compared to the same period in 2019. In 2020, COVID-19-related acute exacerbations had a significantly worse prognosis than non-COVID-19-related acute exacerbations in both 30-day and 90-day mortality. Because the prognosis of AE-ILD associated with COVID-19 is extremely poor, prevention of COVID-19 is especially important for patients with ILD.

Acute exacerbation of idiopathic pulmonary fibrosis after SARS-CoV-2 vaccination

“…A full inpatient evaluation was performed and the patient was diagnosed with acute exacerbation (AE) of f-ILD (AE-f-ILD), raising a question on the relationship between SARS-CoV-2 vaccination and AE. Since recent studies have reported high mortality among f-ILD patients with SARS-CoV-2 infection [ 3 , 4 ], this case has potential clinical significance and we present the clinical course below with some discussion.…”

Successful Treatment with High-dose Steroids for Acute Exacerbation of Idiopathic Pulmonary Fibrosis Triggered by COVID-19

“…These data indicate that AE-IPF triggered by COVID-19 results in greater disease severity than idiopathic and other infection-triggered AE-IPF. Although the 90-day mortality rate of AE-ILD triggered by COVID-19 is especially high (75%), our patient recovered without severe disability with steroid pulse therapy from the early stage of the disease onset ( 21 ). These findings suggest that the early initiation of intensive treatment, including pulse steroid therapy, may be beneficial for patients with AE-IPF triggered by COVID-19.…”

“…Song et al noted no marked differences in the prognosis between patients with “idiopathic” AE and those whose condition was triggered by infection ( 20 ). In contrast, Kondoh et al reported that AE-ILD triggered by COVID-19 had a worse prognosis than that triggered by other causes ( 21 ). Furthermore, Drake et al reported that patients with COVID-19 with preexisting ILD had a significantly higher mortality than those without ILD ( 5 ).…”

COVID-19-Triggered Acute Exacerbation of IPF, an Underdiagnosed Clinical Entity With Two-Peaked Respiratory Failure: A Case Report and Literature Review

“…Therefore, one of the reasons for a poor prognosis of COVID-19 in ILD patients is assumed to be acute exacerbation of interstitial lung disease (AE-ILD). In fact, a Japanese nationwide survey reported 12 suspected cases of AE-ILD associated with COVID-19 ( 8 ). However, this lethal complication is difficult to distinguish from severe COVID-19 on the basis of clinical manifestations.…”

“…As the pandemic of COVID-19 being prolonged, increasing number of cases with chronic ILDs who developed severe respiratory failure by complication with COVID-19 has been reported. We reviewed and summarized them in Table 2 (8,11,12,(16)(17)(18)(19). The majority of the cases developed respiratory failure with newly-emerged GGOs simultaneously with the diagnosis of COVID-19, therefore treated with combination of antiviral and immunomodulation therapy against COVID-19.…”