Background

The impact of pre-existing interstitial lung disease (ILD) on the severity and mortality of COVID-19 remains largely unknown. The purpose of this meta-analysis was to investigate the prevalence of ILD among patients with COVID-19 and figure out the relationship between ILD and the poor clinical outcomes of COVID-19.

Methods

A systematic literature search was conducted in the PubMed, EMBASE, Web of Science and MedRxiv Database from 1 January 2020 to 26 May 2021.

Results

15 studies with 135,263 COVID-19 patients were included for analysis of ILD prevalence. The pooled prevalence of comorbid ILD in patients with COVID-19 was 1.4% (95% CI, 1.1%-1.8%, I² = 91%) with significant between-study heterogeneity. Moreover, the prevalence of ILD in non-survival patients with COVID-19 was 2.728-folds higher than that in corresponding survival patients (RR = 2.728, 95% CI 1.162–6.408, I² = 54%, p = 0.021). Additionally, 2–3 studies were included for comparison analysis of clinical outcome between COVID-19 patients with and without ILD. The results showed that the mortality of COVID-19 patients with ILD was remarkably elevated compared with patients without ILD (RR = 2.454, 95% CI 1.111–5.421, I² = 87%, p = 0.026). Meanwhile, the pooled RR of ICU admission for ILD vs. non-ILD cases with COVID-19 was 3.064 (95% CI 1.889–4.972, I² = 0, p < 0.0001). No significant difference in utilizing rate of mechanical ventilation was observed between COVID-19 patients with and without ILD.

Conclusions

There is great variability in ILD prevalence among patients with COVID-19 across the globe. Pre-existing ILD is associated with higher severity and mortality of COVID-19.

中文翻译：

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2019 年冠状病毒病患者的既往间质性肺病：一项荟萃分析

背景

先前存在的间质性肺病 (ILD) 对 COVID-19 的严重性和死亡率的影响在很大程度上仍然未知。这项荟萃分析的目的是调查 COVID-19 患者中 ILD 的患病率，并弄清 ILD 与 COVID-19 不良临床结果之间的关系。

方法

从 2020 年 1 月 1 日到 2021 年 5 月 26 日，在 PubMed、EMBASE、Web of Science 和 MedRxiv 数据库中进行了系统的文献检索。

结果

纳入了 15 项涉及 135,263 名 COVID-19 患者的研究以分析 ILD 患病率。^{COVID -} 19 患者合并 ILD 的合并患病率为 1.4%（95% CI，1.1%-1.8%，I2  =  91%），具有显着的研究间异质性。此外，未存活的 COVID-19 患者的 ILD 患病率是相应存活患者的 2.728 倍（RR = 2.728，95% CI 1.162–6.408，I 2 = 54%，p ⁼  0.021 ）  。此外，还纳入了 2-3 项研究，用于比较分析伴有和不伴 ILD 的 COVID-19 患者的临床结果。结果显示，与无 ILD 患者相比，COVID-19 伴 ILD 患者的死亡率显着升高（RR = 2.454，​​95% CI 1.111–5.421，I ²  = 87%，p  = 0.026)。同时，ILD 与 COVID-19 非 ILD 病例入住 ICU 的汇总 RR 为 3.064（95% CI 1.889–4.972，I ²  = 0，p  < 0.0001）。在有和没有间质性肺病的 COVID-19 患者之间，机械通气利用率没有显着差异。

结论

全球 COVID-19 患者的间质性肺病患病率存在​​很大差异。先前存在的 ILD 与 COVID-19 的严重程度和死亡率较高有关。