679: The Impact of Covid-19 Infection on Outcomes of Acute Interstitial Pneumonia: 2020-2022 Nis Analysis

Introduction: Although clinical studies have shown that COVID-19 infection can result in worse outcomes in patients with interstitial lung diseases, there is a paucity of data on the impact of concurrent COVID-19 infection on the clinical outcomes of patients with acute interstitial pneumonia (AIP). This National Inpatient Sample (NIS) analysis aims to determine the impact of COVID-19 infection on outcomes of acute interstitial pneumonia. Methods: We identified hospitalized patients with COVID-19 infection and those with AIP from the 2020-2022 NIS database, a part of the Healthcare Cost and Utilization Project database. STATA/MP 17.0 software was used for statistical analysis. Multivariate logistic regression analysis was performed. Results: There were 5,934,565 patients with COVID-19 infection, and 4,790 patients with AIP. The patients with AIP were stratified based on their COVID-19 status. There were 4300 patients with AIP without COVID-19 infection and 490 patients with AIP and COVID-19 infection. Caucasians, patients in the lowest national income quartile and those with Medicaid insurance constituted the largest groups in their perspective categories. Major outcomes comparing patients with AIP with and without Covid 19 were as follows: Noninvasive ventilation (NIV) 30.6% versus 17.7% with an adjusted OR of 2.51, p-value = 0.009; Invasive Mechanical Ventilation (IMV) 28.6% versus 20.5% with an adjusted OR of 1.71 with a confidence interval (CI) of (1.00-2.95), nonsignificant; length of hospital stay (LOS) 17.7 days versus 10.3 days, with an adjusted OR of 9.60; p < 0.001. The mortality rate of 32.6 % versus 18.7 % with an adjusted odds ratio (OR) of 3.65; p-value < 0.001. Conclusions: Our NIS analysis demonstrates that COVID-19 infection resulted in more severe outcomes of acute interstitial pneumonia with a higher mortality rate, higher need for noninvasive ventilation and longer hospital stay. The use of mechanical ventilation did not differ significantly between the two groups and mirrors other non-COVID conditions associated with AIP. Disease-modifying interventions should be explored to improve outcomes.