Moderate or Severe Impairment in Pulmonary Function is Associated with Mortality in Sarcoidosis Patients Infected with S
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COVID-19 AND SARCOIDOSIS
Moderate or Severe Impairment in Pulmonary Function is Associated with Mortality in Sarcoidosis Patients Infected with SARS‑CoV‑2 Adam S. Morgenthau1 · Matthew A. Levin2 · Robert Freeman3 · David L. Reich2 · Eyal Klang3 Received: 12 June 2020 / Accepted: 27 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To investigate whether sarcoidosis patients infected with SARS-CoV-2 are at risk for adverse disease outcomes. Study Design and Methods This retrospective study was conducted in five hospitals within the Mount Sinai Health System during March 1, 2020 to July 29, 2020. All patients diagnosed with COVID-19 were included in the study. We identified sarcoidosis patients who met diagnostic criteria for sarcoidosis according to accepted guidelines. An adverse disease outcome was defined as the presence of intubation and mechanical ventilation or in-hospital mortality. In sarcoidosis patients, we reported (when available) the results of pulmonary function testing measured within 3 years prior to the time of SARS‑CoV‑2 infection. A multivariable logistic regression model was used to generate an adjusted odds ratio (aOR) to evaluate sarcoidosis as a risk factor for an adverse outcome. The same model was used to analyze sarcoidosis patients with moderate and/or severe impairment in pulmonary function. Results The study included 7337 patients, 37 of whom (0.5%) had sarcoidosis. The crude rate of developing an adverse outcome was significantly higher in patients with moderately and/or severely impaired pulmonary function (9/14 vs. 3/23, p = 0.003). While the diagnosis of sarcoidosis was not independently associated with risk of an adverse event, (aOR 1.8, 95% CI 0.9–3.6), the diagnosis of sarcoidosis in patients with moderately and/or severely impaired pulmonary function was associated with an adverse outcome (aOR 7.8, 95% CI 2.4–25.8). Conclusion Moderate or severe impairment in pulmonary function is associated with mortality in sarcoidosis patients infected with SARS‑CoV‑2. Keywords COVID-19 · Sarcoidosis · Pulmonary sarcoidosis · Pulmonary function tests
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00408-020-00392-9) contains supplementary material, which is available to authorized users. * Adam S. Morgenthau [email protected] 1
Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA
2
Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
3
Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Sarcoidosis is a systemic inflammatory disease that can affect any organ within the body. Approximately 90% of sarcoidosis patients’ exhibit involvement of the lungs and nearly all patients manifest involvem
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