Introduction Outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with pre-existing idiopathic pulmonary fibrosis (IPF) remain understudied, and it is unknown if IPF is an independent predictor of worse disease course. Herein, we report the clinical outcomes in a large cohort of 251 patients with COVID-19 in the setting of known IPF. Outcomes were compared with a propensity matched cohort of patients with COVID-19 without IPF. Methods Analysis of a federated multicentre research network TriNetX was performed including patients more than 16 years of age diagnosed with SARS-CoV-2 infection. Outcomes in patients diagnosed as positive for SARS-CoV-2 infection with concurrent IPF were compared with a propensity matched cohort of patients without IPF. Results A total of 311 060 patients with SARS-CoV-2 infection on the research network were identified, 251 patients (0.08%) carried a diagnosis of IPF. Mean age of patients with IPF was 68.30±12.20 years, with male predominance (n=143, 56.97%). Comorbidities including chronic lower respiratory diseases, diabetes mellitus, ischaemic heart disease and chronic kidney disease were more common in patients with IPF when compared with the non-IPF cohort. After propensity matching, higher rates of composite primary outcome (death or mechanical ventilation) at 30 and 60 days, as well as need for hospitalisation, critical care, and acute kidney injury were observed in the IPF cohort. Conclusion Poor outcomes of COVID-19 disease were observed in patients with IPF after robust matching of confounders. Our data confirm that patients with IPF constitute a high-risk cohort for poor outcomes related to COVID-19 disease. Data are available upon reasonable request. Data can be made available upon reasonable request.

中文翻译：

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特发性肺纤维化患者 COVID-19 临床预后不佳：倾向匹配的多中心研究网络分析

引言 严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染先前存在的特发性肺纤维化 (IPF) 患者的结果仍未得到充分研究，并且 IPF 是否是更严重病程的独立预测因子尚不清楚。在此，我们报告了 251 名 COVID-19 患者在已知 IPF 的大型队列中的临床结果。结果与没有 IPF 的 COVID-19 患者的倾向匹配队列进行了比较。方法对联合多中心研究网络 TriNetX 进行了分析，其中包括诊断为 SARS-CoV-2 感染的 16 岁以上患者。将诊断为 SARS-CoV-2 感染并并发 IPF 的患者的结果与没有 IPF 的倾向匹配的患者队列进行比较。结果 研究网络共识别出 311 060 名 SARS-CoV-2 感染患者，251 名患者（0.08%）被诊断为 IPF。IPF 患者的平均年龄为 68.30±12.20 岁，男性为主（n=143，56.97%）。与非 IPF 队列相比，IPF 患者的慢性下呼吸道疾病、糖尿病、缺血性心脏病和慢性肾病等合并症更为常见。在倾向匹配后，在 IPF 队列中观察到在 30 天和 60 天时复合主要结局（死亡或机械通气）以及住院、重症监护和急性肾损伤的发生率更高。结论 在对混杂因素进行稳健匹配后，在 IPF 患者中观察到 COVID-19 疾病的不良结局。我们的数据证实，IPF 患者构成了与 COVID-19 疾病相关的不良结果的高风险队列。可应合理要求提供数据。可应合理要求提供数据。