During the coronavirus disease 2019(COVID-19)pandemic,the disease severity of COVID-19 varied widely depending on the underlying conditions of infected patients.[1]Interstitial lung disease(ILD)comprises a group of di...During the coronavirus disease 2019(COVID-19)pandemic,the disease severity of COVID-19 varied widely depending on the underlying conditions of infected patients.[1]Interstitial lung disease(ILD)comprises a group of diffuse parenchymal lung disorders associated with substantial morbidity and mortality.[2]Currently,multi-center data evaluating outcomes in patients with pre-existing ILD and COVID-19 are limited in China.Our study was based on a national multi-center prospective ILD registry study conducted by our group in China from 2017.We followed up patients in this cohort for the infection of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),and described their characteristics,disease severity and outcomes.We also explored the risk factors for COVID-19 severity and outcomes.展开更多
Background:The presence of fibrosis is a criterion for subtype classification in the newly updated hypersensitivity pneumonitis(HP)guidelines.The present study aimed to summarize differences in clinical characteristic...Background:The presence of fibrosis is a criterion for subtype classification in the newly updated hypersensitivity pneumonitis(HP)guidelines.The present study aimed to summarize differences in clinical characteristics and prognosis of non-fibrotic hypersensitivity pneumonitis(NFHP)and fibrotic hypersensitivity pneumonitis(FHP)and explore factors associated with the presence of fibrosis.Methods:In this prospective cohort study,patients diagnosed with HP through a multidisciplinary discussion were enrolled.Collected data included demographic and clinical characteristics,laboratory findings,and radiologic and histopathological features.Logistic regression analyses were performed to explore factors related to the presence of fibrosis.Results:A total of 202 patients with HP were enrolled,including 87(43.1%)NFHP patients and 115(56.9%)FHP patients.Patients with FHP were older and more frequently presented with dyspnea,crackles,and digital clubbing than patients with NFHP.Serum levels of carcinoembryonic antigen,carbohydrate antigen 125,carbohydrate antigen 153,gastrin-releasing peptide precursor,squamous cell carcinoma antigen,and antigen cytokeratin 21-1,and count of bronchoalveolar lavage(BAL)eosinophils were higher in the FHP group than in the NFHP group.BAL lymphocytosis was present in both groups,but less pronounced in the FHP group.Multivariable regression analyses revealed that older age,<20%of lymphocyte in BAL,and≥1.75%of eosinophil in BAL were risk factors for the development of FHP.Twelve patients developed adverse outcomes,with a median survival time of 12.5 months,all of whom had FHP.Conclusions:Older age,<20%of lymphocyte in BAL,and≥1.75%of eosinophil in BAL were risk factors associated with the development of FHP.Prognosis of patients with NFHP was better than that of patients with FHP.These results may provide insights into the mechanisms of fibrosis in HP.展开更多
基金supported by grants from the National Key Research&Development Program of China(Nos.2021YFC2500700 and 2016YFC0901101).
文摘During the coronavirus disease 2019(COVID-19)pandemic,the disease severity of COVID-19 varied widely depending on the underlying conditions of infected patients.[1]Interstitial lung disease(ILD)comprises a group of diffuse parenchymal lung disorders associated with substantial morbidity and mortality.[2]Currently,multi-center data evaluating outcomes in patients with pre-existing ILD and COVID-19 are limited in China.Our study was based on a national multi-center prospective ILD registry study conducted by our group in China from 2017.We followed up patients in this cohort for the infection of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),and described their characteristics,disease severity and outcomes.We also explored the risk factors for COVID-19 severity and outcomes.
基金National Key Technologies R&D Program of China(Nos.2021YFC2500700 and 2016YFC0901100)
文摘Background:The presence of fibrosis is a criterion for subtype classification in the newly updated hypersensitivity pneumonitis(HP)guidelines.The present study aimed to summarize differences in clinical characteristics and prognosis of non-fibrotic hypersensitivity pneumonitis(NFHP)and fibrotic hypersensitivity pneumonitis(FHP)and explore factors associated with the presence of fibrosis.Methods:In this prospective cohort study,patients diagnosed with HP through a multidisciplinary discussion were enrolled.Collected data included demographic and clinical characteristics,laboratory findings,and radiologic and histopathological features.Logistic regression analyses were performed to explore factors related to the presence of fibrosis.Results:A total of 202 patients with HP were enrolled,including 87(43.1%)NFHP patients and 115(56.9%)FHP patients.Patients with FHP were older and more frequently presented with dyspnea,crackles,and digital clubbing than patients with NFHP.Serum levels of carcinoembryonic antigen,carbohydrate antigen 125,carbohydrate antigen 153,gastrin-releasing peptide precursor,squamous cell carcinoma antigen,and antigen cytokeratin 21-1,and count of bronchoalveolar lavage(BAL)eosinophils were higher in the FHP group than in the NFHP group.BAL lymphocytosis was present in both groups,but less pronounced in the FHP group.Multivariable regression analyses revealed that older age,<20%of lymphocyte in BAL,and≥1.75%of eosinophil in BAL were risk factors for the development of FHP.Twelve patients developed adverse outcomes,with a median survival time of 12.5 months,all of whom had FHP.Conclusions:Older age,<20%of lymphocyte in BAL,and≥1.75%of eosinophil in BAL were risk factors associated with the development of FHP.Prognosis of patients with NFHP was better than that of patients with FHP.These results may provide insights into the mechanisms of fibrosis in HP.
