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Original Article
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Korean J Intern Med. 2025;40(4):634-644. Published online July 1, 2025.
DOI: https://doi.org/10.3904/kjim.2024.388
- Clinical impacts of COVID-19 on severe exacerbation and mortality in interstitial lung disease: prognosis 30 days after infection
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Bo-Guen Kim1, Sun-Kyung Lee2,3, Dong Won Park2, Tai Sun Park2, Ji-Yong Moon2, Tae-Hyung Kim2, Sang-Heon Kim2, Ho Joo Yoon2, Hyun Lee2
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1Division of Pulmonary Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea
2Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
3Department of Mathematics, College of Natural Sciences, Hanyang University, Seoul, Korea
- Corresponding author: Hyun Lee ,Tel: +82-2-2290-8336, Fax: +82-2-2298-9183, Email: namuhanayeyo@naver.com
- Received: November 15, 2024; Revised: January 10, 2025 Accepted: January 28, 2025.
- Abstract
- 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.
Keywords :COVID-19; Interstitial lung diseases; Mortality
