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Korean J Intern Med . Clinical impacts of COVID-19 on severe exacerbation and mortality in interstitial lung disease: prognosis 30 days after infec

tetano

Editor, Senior Moderator
Korean J Intern Med


. 2025 Jul;40(4):634-644.
doi: 10.3904/kjim.2024.388. Epub 2025 Jul 1. Clinical impacts of COVID-19 on severe exacerbation and mortality in interstitial lung disease: prognosis 30 days after infection

Bo-Guen Kim[SUP] 1 [/SUP], Sun-Kyung Lee[SUP] 2 3 [/SUP], Dong Won Park[SUP] 2 [/SUP], Tai Sun Park[SUP] 2 [/SUP], Ji-Yong Moon[SUP] 2 [/SUP], Tae-Hyung Kim[SUP] 2 [/SUP], Sang-Heon Kim[SUP] 2 [/SUP], Ho Joo Yoon[SUP] 2 [/SUP], Hyun Lee[SUP] 2 [/SUP]



Affiliations
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.
Conclusion: 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.

 
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