Interstitial lung disease independently associated with higher risk for COVID-19 severity and mortality: A meta-analysis of adjusted effect estimates.

ABSTRACT

OBJECTIVE: The aim of this study was to address the association between interstitial lung disease and the risk for severity and mortality among patients with coronavirus disease 2019 (COVID-19). METHODS: The electronic databases of PubMed, Web of Science and EMBASE were systematically searched. The pooled effect size with 95 % confidence interval (CI) was computed by a random-effects meta-analysis model. Heterogeneity test, sensitivity analysis, subgroup analysis, meta-regression analysis, Begg's test and Egger's test were performed. RESULTS: A total of sixteen eligible studies with 217,260 COVID-19 patients were enrolled in this meta-analysis. The findings based on adjusted effect estimates indicated that pre-existing interstitial lung disease was significantly associated with higher risk for COVID-19 severity (pooled effect = 1.34 [95 % CI 1.16-1.55]) and mortality (pooled effect = 1.26 [95 % CI 1.09-1.46]). Consistent results were observed in the subgroup analysis stratified by sample size, age, the percentage of male patients, study design, setting, the methods for adjustment and the factors for adjustment. The results of meta-regression demonstrated that sample size, age and region might be the potential sources of heterogeneity. Sensitivity analysis exhibited that our results were stable and robust. No publication bias was observed in Egger's test and Begg's test. CONCLUSION: This meta-analysis on the basis of adjusted effect estimates demonstrated that pre-existing interstitial lung disease was independently associated with significantly higher risk for COVID-19 severity and mortality.