Moderate or Severe Impairment in Pulmonary Function is Associated with Mortality in Sarcoidosis Patients Infected with SARS‑CoV‑2

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.

SARS-CoV-2 Lung Disease in a Patient with Pulmonary Sarcoidosis—Case Report

“…This is in stark contrast to the 5-10% of the general population that required the same type of support [3]. It is suggested that sarcoidosis patients who present with moderate to severe impairment in pulmonary function have an increased mortality rate due to SARS-CoV-2 infection [1,4].…”

“…SARS-CoV-2 related lung disease has resulted in significant morbidity and mortality worldwide [3]. The risk factors for severe SARS-CoV-2 disease include increasing age and comorbidities, with chronic respiratory diseases being among them [1,4].…”

“…Sarcoidosis is a multi-organ granulomatous disease of unknown aetiology [4]. Respiratory system involvement is observed in 90% of patients and presents as isolated symmetrical hilar lymphadenopathy (stage I), perilymphatic and perivascular nodular infiltrates (stage III), or both (stage II) [5].…”

Autoimmune diseases are independently associated with COVID-19 severity: Evidence based on adjusted effect estimates

“…But the conclusions across studies are inconsistent. 1 , 2 , 3 , 4 , 5 , 6 Recently, Liu et al. performed a meta-analysis based on six studies with 2091 cases published in Journal of Infection to investigate the association between autoimmune diseases and severe or dead COVID-19.…”

LUNG Year in Review: 2020

“…We at LUNG were very selective in our acceptance of SARS-CoV-2-related manuscripts, since most submissions were retrospective, descriptive series of patients, often small in number and not contributing to the extant published literature. Four notable exceptions included the first study reporting an association of COVID-19 outcome with levels of surfactant protein D [ 21 ]; a study of the effect of COVID-19 on patients with sarcoidosis [ 22 ]; a State-of-the-Art review on the relevance of the ACE-2 receptor in SARS-CoV-2 infection [ 14 ]; and an editorial examining chronic cough as a residual effect of the illness [ 23 ].…”