结缔组织病相关间质性肺病患者的Covid-19病程

H. Satış, Y. Ünsal, A. Tufan
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摘要

导语:2019冠状病毒(COVID-19)感染已迅速蔓延,导致全球大流行。虽然大多数患者的临床病程良好,从无症状携带到简单的流感感染,但在一些患者中可以看到肺炎,甚至多器官衰竭和死亡。在与患者预后更差相关的研究中,它与肺部疾病患者死亡率增加有关。本研究旨在揭示结缔组织病(CTD-ILD)间质性肺疾病患者的死亡率及与COVID-19相关的可能预后因素。材料和方法:在三级转诊中心,回顾性分析了先前诊断为CTD-ILD的患者。从电子记录中回顾性获取2020年4月1日至2021年4月1日期间与ILD疾病、COVID-19感染和死亡率相关的患者数据。主要终点为COVID-19感染第30天死亡。结果:271例患者被诊断为CTD-ILD。经聚合酶链反应确诊新冠肺炎感染74例。随访期间死亡29例,其中COVID-19感染相关死亡率13例(17.5% vs 8.1%, p:0.045)。与死亡率相关的COVID感染更常见于强迫肺活量下降、吸烟史、病程延长和类风湿性关节炎患者。在多变量回归分析中,只有用力肺活量下降与预后不良有关。结论:COVID-19感染与CTD-ILD患者死亡风险增加有关。肺活量下降是一个不良的预后危险因素
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Covid-19 Course in Connective Tissue Disease-Related Interstitial Lung Disease Patients
Introduction: Coronovirus 2019 (COVID-19) infection has spread rapidly, causing a worldwide pandemic. Although a good clinical course ranging from asymptomatic carriage to a simple flu infection is encountered in most patients, pneumonia and even multi-organ failure and mortality can be seen in some patients. In studies on which patients are more associated with a worse prognosis, it has been associated with increased mortality in patients with lung disease. In this study, it was aimed to show the mortality rate and possible prognostic factors associated with COVID-19 in patients with interstitial lung disease due to connective tissue disease (CTD-ILD). Materials and Methods: In a tertiary referral centre, patients with previously diagnosed CTD-ILD were retrospectively reviewed. Between 1st April 2020 to 1st April 2021 patient data related to ILD disease, COVID-19 infection and mortality were obtained from electronic records retrospectively. The primary outcome was death on day 30 of COVID-19 infection Results: There were 271patients diagnosed with CTD-ILD. 74 patients had COVID-19 infection, which was confirmed by polymerase chain reaction. 29 patients were dead during the followed-up period of whom 13 patients had COVID-19 infection-related mortality (17.5% vs 8.1%, p:0.045). COVID infection related to mortality was more frequently seen in patients with decreased forced vital capacity , smoking history, extended disease and rheumatoid arthritis. On multivariate regression analysis, only decreased forced vital capacity were related to poor outcomes. Conclusion : COVID-19 infection is related to increased risk of mortality in CTD-ILD patients. Decreased forced vital capacity is a poor prognostic risk factor
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