COVID-19 Associated Interstitial Lung Disease - An Emerging Entity

Abstract

Background: COVID-19 disease associated pulmonary sequalae has been increasingly reported after recovery from acute infection. Therefore, we aim to explore the charactersitics of interstitial lung disease in patients with COVID-19.Methods: An observational study was conducted in patients with COVID-19 associated ILD from April 2020 till September 2020. Patients ≥18 years of age with COVID-19 who were diagnosed with ILD based on respiratory symptoms and HRCT chest imaging after the recovery phase of COVID-19 infection were recruited. Data was recorded on a structured proforma, and descriptive analysis was performed using Stata version 12.1.Results: A total of 30 patients with COVID-associated ILD were identified. The mean age of patients was 59.14 (SD 12.60) and 27 (90%) were males. Four HRCT patterns of interstitial lung disease were seen; organizing pneumonia in 10 (33.33%), non-specific interstitial pneumonitis in 17 (56.67%), usual interstitial pneumonitis in 12 (40%) and probable usual interstitial pneumonitis in 14 (46.67%). Diffuse involvement was found in 15 (50%) patients, while peripheral predominance in 15 (50%) and other significant findings were seen in 8 (26.67%) patients. All patients were treated with corticosteroids. The case fatality rate was 16.67%. Amongst the survivors, 8 (32%) recovered completely, 9 (36%) improved, while 8 (32%) patients had static or progressive disease.Conclusions: This is the first study from Southeast Asia that identified COVID-associated interstitial lung disease in patients who had no pre-existing lung disease, highlighting the importance of timely recognition and treatment of an entity that might lead to fatal outcome.