ArticleBMJ open respiratory research2025
Association of vaccination status and immunosuppression with mortality of SARS-CoV-2 infection in patients with fibrotic interstitial lung disease.
Article in BMJ open respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThere are limited data exploring the outcome following SARS-CoV-2 infection in fibrotic interstitial lung disease (fILD). Our goal was to determine the association of vaccination for SARS-CoV-2 with both SARS-CoV-2 infection and subsequent 90-day mortality in fILD. Our second objective was to determine the association of immunosuppressive use with both SARS-CoV-2 infection and subsequent 90-day mortality in fILD.
methodsPatients with fILD enrolled in the Canadian Registry for Pulmonary Fibrosis with comprehensive access to data on SARS-CoV-2 vaccination and PCR-confirmed infection were included. Associations of vaccination status and current immunosuppressant use with SARS-CoV-2 infection and subsequent 90-day mortality were tested using Fisher's exact test and subsequently multivariable logistic regression adjusting for age, sex, pre-identified comorbidities, forced vital capacity and diffusing capacity of the lung for carbon monoxide.
resultsOf 1452 total patients with fILD, 138 tested positive for SARS-CoV-2. On adjusted analysis, vaccination for SARS-CoV-2 was associated with a 60% reduction in the odds of infection (OR 0.40, 95% CI 0.24 to 0.67 p<0.001) and a 97% reduction in the odds of 90-day mortality following infection (OR 0.03, 95% CI 0.0007 to 0.26, p=0.01). SARS-CoV-2 was diagnosed in 13% of patients on an immunosuppressant and 9% of those not (OR 1.4, 95% CI 1.0 to 2.1, p=0.04). Immunosuppressant use was not associated with 90-day mortality after SARS-CoV-2 infection on adjusted analysis.
conclusionIn patients with fILD, vaccination against SARS-CoV-2 was associated with decreased frequency of SARS-CoV-2 infection and subsequent 90-day mortality, while current use of immunosuppressive medication was associated with risk of infection but only a trend for subsequent 90-day mortality.
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