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Patients with idiopathic pulmonary fibrosis have poor clinical outcomes with COVID-19 disease: a propensity matched multicentre research network analysis

Naqvi, Syeda Fatima; Lakhani, Dhairya A; Sohail, Amir Humza; Maurer, James; Sofka, Sarah; Sarwari, Arif; Hadi, Yousaf B
INTRODUCTION:Outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with pre-existing idiopathic pulmonary fibrosis (IPF) remain understudied, and it is unknown if IPF is an independent predictor of worse disease course. Herein, we report the clinical outcomes in a large cohort of 251 patients with COVID-19 in the setting of known IPF. Outcomes were compared with a propensity matched cohort of patients with COVID-19 without IPF. METHODS:Analysis of a federated multicentre research network TriNetX was performed including patients more than 16 years of age diagnosed with SARS-CoV-2 infection. Outcomes in patients diagnosed as positive for SARS-CoV-2 infection with concurrent IPF were compared with a propensity matched cohort of patients without IPF. RESULTS:A total of 311 060 patients with SARS-CoV-2 infection on the research network were identified, 251 patients (0.08%) carried a diagnosis of IPF. Mean age of patients with IPF was 68.30±12.20 years, with male predominance (n=143, 56.97%). Comorbidities including chronic lower respiratory diseases, diabetes mellitus, ischaemic heart disease and chronic kidney disease were more common in patients with IPF when compared with the non-IPF cohort. After propensity matching, higher rates of composite primary outcome (death or mechanical ventilation) at 30 and 60 days, as well as need for hospitalisation, critical care, and acute kidney injury were observed in the IPF cohort. CONCLUSION:Poor outcomes of COVID-19 disease were observed in patients with IPF after robust matching of confounders. Our data confirm that patients with IPF constitute a high-risk cohort for poor outcomes related to COVID-19 disease.
PMCID:8354761
PMID: 34376400
ISSN: 2052-4439
CID: 5004372

Warfarin Use Is Associated with Increased Mortality at One Year in Patients with Idiopathic Pulmonary Fibrosis

Naqvi, Syeda Fatima; Sohail, Amir Humza; Lakhani, Dhairya A; Maurer, James; Sofka, Sarah; Hadi, Yousaf B
Objectives/UNASSIGNED:We studied the safety and efficacy of warfarin compared to direct acting oral anticoagulant use in patients with IPF. Methods/UNASSIGNED:We conducted a retrospective cohort study of all patients with IPF who were prescribed warfarin or direct acting oral anticoagulants (DOACs) for cardiac or thromboembolic indications and followed at our institute for their care. Univariate tests and multivariable logistic regression analyses were used for assessing association of variables with outcomes. Results/UNASSIGNED:value: 0.007). Conclusion/UNASSIGNED:In our study of patients with IPF requiring anticoagulants, we noted statistically significant higher mortality with warfarin anticoagulation when compared to DOAC use. Further larger prospective studies are needed to confirm these findings.
PMCID:8639231
PMID: 34868680
ISSN: 2090-1844
CID: 5082882

Adenocarcinoma arising at ileostomy sites: Two cases and a review of the literature

Procaccino, Lauren; Rehman, Sameer; Abdurakhmanov, Alexander; McWhorter, Peter; La Gamma, Nicholas; Bhaskaran, Madhu C; Maurer, James; Grimaldi, Gregory M; Rilo, Horacio; Nicastro, Jeffrey; Coppa, Gene; Molmenti, Ernesto P; Procaccino, John
Total colectomy with ileostomy placement is a treatment for patients with inflammatory bowel disease or familial adenomatous polyposis (FAP). A rare and late complication of this treatment is carcinoma arising at the ileostomy site. We describe two such cases: a 78-year-old male 30 years after subtotal colectomy and ileostomy for FAP, and an 85-year-old male 50 years after colectomy and ileostomy for ulcerative colitis. The long latency period between creation of the ileostomies and development of carcinoma suggests a chronic metaplasia due to an irritating/inflammatory causative factor. Surgical excision of the mass and relocation of the stoma is the mainstay of therapy, with possible benefits from adjuvant chemotherapy. Newly developed lesions at stoma sites should be biopsied to rule out the possibility of this rare ileostomy complication.
PMID: 26131331
ISSN: 1948-9366
CID: 3491032