Introduction:

In March 2020, WHO declared the COVID-19 pandemic, leading to an increase in hospital admissions due to respiratory failure caused by viral pneumonitis.  Patients with underlying interstitial lung disease (ILD) are particularly vulnerable to acute respiratory deterioration. In this study, we examined admission patterns and response to oxygen therapy in patients with and without pre-existing ILD.

Methods:

We identified all patients admitted to Glenfield Hospital, a cardio-respiratory tertiary centre, who required 10 litres/min or more of oxygen therapy. Using ICD-10 coding, we classified patients as either ILD or not known ILD. We looked at quarterly data from January 2019 to June 2022, with mortality as the primary outcome.

Results:

Of the 3718 admissions with our defined inclusion criteria, we observed four quarterly peaks, likely related to COVID-19. ILD patients accounted for 342 admissions (9%) and peaked in the 4th quarter of 2021, likely reflecting the self-isolation period prior to the peak.   

The overall mortality was at 48%, with higher mortality observed in the ILD group at 83% (285 out of 342) compared to the non-ILD group (46%). Based on these data, ILD patients appeared to do worse if they had continuous positive airway pressure (CPAP).

Interestingly, ILD patients who tested negative for covid-19 seem to have higher mortality than covid-19 positive ILD group.

Conclusions:

This data sheds light on worse outcomes for patients with ILD with acute respiratory failure. It is essential to explore optimal management strategies and improve the quality of care provided to these vulnerable patients.