The observed NSIP‐to‐UIP shift highlights a multistep process potentially driven by SARS‐CoV‐2, underscoring the need for close ILD monitoring in ASD patients.
Abstract
The objective of this study was to assess the impact of severe COVID‐19 pneumonia on the course of interstitial lung disease (ILD) in autoimmune systemic diseases (ASD). We conducted a multicentre case series of 27 ASD patients (20 systemic sclerosis, 4 rheumatoid arthritis, 1 interstitial pneumonia with autoimmune features, 1 dermatomyositis, 1 eosinophilic granulomatosis with polyangiitis) hospitalised for severe COVID‐19. Clinical data, pulmonary function tests and HRCT before and after infection were analysed. Four patients died during acute COVID‐19. Among the 23 survivors, 10 developed new symptomatic ILD and 13 showed worsening of pre‐existing ILD. Six exhibited significant HRCT progression, including NSIP‐to‐UIP transition; one developed lung adenocarcinoma. Despite treatment, five more patients died during follow‐up from progressive ILD. Overall mortality approached one‐third, with systemic sclerosis most affected. Severe COVID‐19 may trigger or accelerate ASD‐related ILD. The observed NSIP‐to‐UIP shift highlights a multistep process potentially driven by SARS‐CoV‐2, underscoring the need for close ILD monitoring in ASD patients.
An adult patient with underlying ILD who developed acute respiratory deterioration in the setting of primary parvovirus B19 infection is reported, highlighting the importance of considering parvovirus B19 infection as a potential contributor to acute respiratory deterioration in patients with underlying ILD.
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