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Published on: December 19, 2020
Association Between COVID-19 Infection and Pulmonary Fibrosis: A Nested Case-Control Study
Ronza Najjar-Debbiny1, Ofra Barnett-Griness2, Johad Khoury3
1Infection Control and Prevention Unit, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Coronavirus disease (COVID-19) significantly increases pulmonary fibrosis risk, especially with severe illness. This association highlights a critical long-term health concern following COVID-19 infection.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Epidemiology
Background:
- Pulmonary fibrosis is a serious condition with limited understanding of its connection to COVID-19.
- Existing data on the link between COVID-19 and pulmonary fibrosis are scarce.
Purpose of the Study:
- To investigate the association between COVID-19 and the subsequent development of pulmonary fibrosis.
- To determine if COVID-19 severity influences the risk of pulmonary fibrosis.
Main Methods:
- A nested case-control study was performed on a large cohort of over 2.8 million adults in Israel.
- 1284 patients diagnosed with pulmonary fibrosis were matched with 12,840 controls.
- A 60-day lag time was implemented to mitigate surveillance bias in assessing COVID-19 history and severity.
Main Results:
- Patients with COVID-19 had a 1.80-fold increased odds of developing pulmonary fibrosis compared to those without COVID-19.
- The risk of pulmonary fibrosis increased with COVID-19 severity: odds ratios of 1.33, 2.98, and 9.30 for mild, moderate, and severe cases, respectively.
- Even with a 180-day lag, severe COVID-19 remained significantly associated with a higher risk of pulmonary fibrosis.
Conclusions:
- COVID-19 is associated with an elevated risk of pulmonary fibrosis.
- The risk of pulmonary fibrosis following COVID-19 correlates directly with the severity of the initial infection.
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