Clinical impact of hospitalizations for sars-cov-2 infection in idiopathic pulmonary fibrosis patients

SESSION TITLE: Diffuse Lung Disease Posters 7 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: We aimed to look at impact of idiopathic pulmonary fibrosis (IPF) on clinical outcomes of patients admitted with COVID-19 infection. METHODS: We looked at hospitalizations in 2020 using the discharge data from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. We identified those with a principal diagnosis COVID-19 and secondary diagnosis of IPF using the International Classification of Diseases, 10th revision, Clinical Modification codes; Statistical significance was defined as p<.05. Statistical analyses were performed using STATA-17. We adjusted for all baseline demographics and co-morbidities including hypertension, diabetes mellitus, chronic obstructive pulmonary disease, coronary artery disease and chronic kidney disease. RESULTS: 1,018,915 adults were hospitalized with COVID-19 in 2020; 910 also had IPF. Patients with COVID-19 and IPF were less likely to be female (37% vs 47%), older (72 vs 64 years), and had higher proportion of Caucasian descent (69% vs 52%) and Medicare beneficiary status (72% vs 55%) than patients without IPF. 113,180 of the [GDM1] total patients admitted with COVID-19 died. Of these, patients with IPF had significantly higher risk of mortality (adjusted OR 2.65, 95% CI [1.8-3.9], p<0.01), increased need for mechanical ventilation (MV) (adjusted OR 1.9, [95% CI 1.3-2.8, p<0.01], and higher vasopressor needs (adjusted OR 2.2 [95% CI 1.02-4.67] p<0.05) compared to the non-IPF cohort. In addition, IPF group was associated with an increase in mean length of stay [GDM2] (LOS) (11.2 vs 7.5 days, adjusted difference 3.29 days longer [95% CI 1.25-5.33] p<0.01) and significant increase in mean total hospitalization charges ($140,790 vs $79,045, adjusted difference $60,577 more [95% CI 8,116-113,037] p<0.03] compared to COVID-19 without IPF. The odds of requiring MV early on (within 24 hours of admission) were similar (adjusted OR 1.4 [95% CI 0.8-2.5] p=0.2). CONCLUSIONS: In hospitalizations for COVID-19 in 2020, despite adjusting for baseline demographics, co-morbidity of IPF observed differences in gender, age and race. IPF increased the odds of mortality, MV and vasopressor needs, and significantly increased mean LOS and mean total hospitalization charges. Further studies are needed to study this subpopulation during the post-vaccination era to observe the effects of outcomes in these patients. CLINICAL IMPLICATIONS: Our study highlights the significant burden of COVID-19 hospitalization on both patients with IPF and the healthcare system in the pre-vaccination era. DISCLOSURES: No relevant relationships by Deepa Gotur, value=Honoraria Removed 12/03/2022 by Deepa Gotur, source=Web Response speakers bureau and consultant relationship with Bohreinger ingelheim Please note: $5001 - $20000 by Zeenat Safdar, value=Honoraria Consultant and speakers bureau relationship with Genetech Please note: $5001 - $20000 by Zeenat Safdar, value=Consulting fee Consultant and speakers bureau relationship with Actelion pharmaceutical- J & J Please note: $5001 - $20000 by Zeenat Safdar, value=Consulting fee Consultant and speakers bureau relationship with Gilead Sciences Please note: $1001 - $5000 by Zeenat Safdar, value=Consulting fee Removed 03/31/2023 by Zeenat Safdar, source=Web Response Advisory Committee Member relationship with United therapeutics Please note: $5001 - $20000 by Zeenat Safdar, value=Consulting fee No relevant relationships by Omar Tamimi No relevant relationships by Faisal Tamimi