Interstitial lung damage following COVID-19 hospitalisation: an interim analysis of the UKILD Post-COVID study

  1. I Stewart
  2. J Jacob
  3. PM George
  4. PL Molyneaux
  5. JC Porter
  6. RJ Allen
  7. JK Baillie
  8. SL Barratt
  9. P Beirne
  10. SM Bianchi
  11. JF Blaikley
  12. J Chalmers
  13. RC Chambers
  14. N Chadhuri
  15. C Coleman
  16. G Collier
  17. EK Denneny
  18. A Docherty
  19. O Elneima
  20. RA Evans
  21. L Fabbri
  22. MA Gibbons
  23. FV Gleeson
  24. B Gooptu
  25. NJ Greening
  26. B Guillen Guio
  27. IP Hall
  28. NA Hanley
  29. V Harris
  30. EM Harrison
  31. M Heightman
  32. TE Hillman
  33. A Horsley
  34. L Houchen-Wolloff
  35. I Jarrold
  36. SR Johnson
  37. MG Jones
  38. F Khan
  39. R Lawson
  40. OC Leavy
  41. N Lone
  42. M Marks
  43. H McAuley
  44. P Mehta
  45. E Omer
  46. D Parekh
  47. K Piper Hanley
  48. M Platé
  49. J Pearl
  50. K Poinasamy
  51. JK Quint
  52. B Raman
  53. M Richardson
  54. P Rivera-Ortega
  55. LC Saunders
  56. R Saunders
  57. MG Semple
  58. M Sereno
  59. A Shikotra
  60. AJ Simpson
  61. A Singapuri
  62. DJF Smith
  63. M Spears
  64. LG Spencer
  65. S Stanel
  66. D Thickett
  67. AAR Thompson
  68. M Thorpe
  69. R Thwaites
  70. SLF Walsh
  71. S Walker
  72. ND Weatherley
  73. M Weeks
  74. JM Wild
  75. DG Wootton
  76. CE Brightling
  77. LP Ho
  78. LV Wain
  79. RG Jenkins
1 evaluations Published on
Read the full article Related papers
This article on Sciety

Abstract

Introduction

Shared characteristics between COVID-19 and pulmonary fibrosis, including symptoms, genetic architecture, and circulating biomarkers, suggests interstitial lung disease (ILD) development may be associated with SARS-CoV-2 infection.

Methods

The UKILD Post-COVID study planned interim analysis was designed to stratify risk groups and estimate the prevalence of Post-COVID Interstitial Lung Damage (ILDam) using the Post-HOSPitalisation COVID-19 (PHOSP-COVID) Study. Demographics, radiological patterns and missing data were assessed descriptively. Bayes binomial regression was used to estimate the risk ratio of persistent lung damage >10% involvement in linked, clinically indicated CT scans. Indexing thresholds of percent predicted DLco, chest X-ray findings and severity of admission were used to generate risk strata. Number of cases within strata were used to estimate the amount of suspected Post-COVID ILDam.

Results

A total 3702 people were included in the UKILD interim cohort, 2406 completed an early follow-up research visit within 240 days of discharge and 1296 had follow-up through routine clinical review. We linked the cohort to 87 clinically indicated CTs with visually scored radiological patterns (median 119 days from discharge; interquartile range 83 to 155, max 240), of which 74 people had ILDam. ILDam was associated with abnormal chest X-ray (RR 1.21 95%CrI 1.05; 1.40), percent predicted DLco<80% (RR 1.25 95%CrI 1.00; 1.56) and severe admission (RR 1.27 95%CrI 1.07; 1.55). A risk index based on these features suggested 6.9% of the interim cohort had moderate to very-high risk of Post-COVID ILDam. Comparable radiological patterns were observed in repeat scans >90 days in a subset of participants.

Conclusion

These interim data highlight that ILDam was not uncommon in clinically indicated thoracic CT up to 8 months following SARS-CoV-2 hospitalisation. Whether the ILDam will progress to ILD is currently unknown, however health services should radiologically and physiologically monitor individuals who have Post-COVID ILDam risk factors.

Related articles

Related articles are currently not available for this article.