Risk factors associated with COVID‐19 pneumonia in Chinese patients with pre‐existing interstitial lung disease during the SARS‐CoV‐2 pandemic

Abstract

AbstractIn China, the emergence of a nationally widespread epidemic infection of severe acute respiratory syndrome coronavirus 2 (SARS‐COV‐2) has appeared within a month since December 7, 2022. To evaluate the risk factors for suffering from coronavirus disease 2019 (COVID‐19) pneumonia due to infection with SARS‐CoV‐2 in different kinds of interstitial lung disease (ILD) patients with diverse immunizations, we conducted this retrospective study on 525 patients with ILDs who underwent regular follow‐up in our ILD clinic. Among them, 128 ILD patients (24.4%) suffered from COVID‐19 pneumonia after SARS‐CoV‐2 infection. Patients were older with a male predominance in the pneumonia group than in the nonpneumonia group (65.0 ± 10.0 years vs. 56.4 ± 11.7 years, p < 0.001, 55.5% vs. 39.5%, p = 0.002, respectively). Connective tissue disease‐associated ILD (CTD‐ILD) (25%), idiopathic pulmonary fibrosis (23.4%), and interstitial pneumonia with autoimmune features (21.1%) were the main pre‐existing ILDs in the pneumonia group. In Cox multivariable analysis, only male sex and corticosteroid use were risk factors for COVID‐19 pneumonia after infection. Two or three doses of vaccination were a protective factor for pre‐existing ILD patients suffering from COVID‐19 pneumonia. More than two doses of vaccination were strongly recommended for pre‐existing ILD patients, particularly for males who were administered corticosteroids.