Factors for severe outcomes following SARS-CoV-2 infection in people with cystic fibrosis in Europe.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in people with cystic fibrosis (pwCF) can lead to severe outcomes. METHODS: In this observational study, the European Cystic Fibrosis Society Patient Registry collected data on pwCF and SARS-CoV-2 infection to estimate incidence, describe clinical presentation and investigate factors associated with severe outcomes using multivariable analysis. RESULTS: Up to December 31, 2020, 26 countries reported information on 828 pwCF and SARS-CoV-2 infection. Incidence was 17.2 per 1000 pwCF (95% CI: 16.0-18.4). Median age was 24 years, 48.4% were male and 9.4% had lung transplants. SARS-CoV-2 incidence was higher in lung-transplanted (28.6; 95% CI: 22.7-35.5) versus non-lung-transplanted pwCF (16.6; 95% CI: 15.4-17.8) (p≤0.001).SARS-CoV-2 infection caused symptomatic illness in 75.7%. Factors associated with symptomatic SARS-CoV-2 infection were age >40 years, at least one F508del mutation and pancreatic insufficiency.Overall, 23.7% of pwCF were admitted to hospital, 2.5% of those to intensive care, and regretfully 11 (1.4%) died. Hospitalisation, oxygen therapy, intensive care, respiratory support and death were 2- to 6-fold more frequent in lung-transplanted versus non-lung-transplanted pwCF.Factors associated with hospitalisation and oxygen therapy were lung transplantation, cystic fibrosis-related diabetes (CFRD), moderate or severe lung disease and azithromycin use (often considered a surrogate marker for Pseudomonas aeruginosa infection and poorer lung function). CONCLUSION: SARS-CoV-2 infection yielded high morbidity and hospitalisation in pwCF. PwCF with forced expiratory volume in 1 s <70% predicted, CFRD and those with lung transplants are at particular risk of more severe outcomes.

Coronavirus infection (COVID-19) in children with cystic fibrosis

Objective of the research: to assess the prevalence and course of COVID-19 in children and adolescents with cystic fibrosis (CF) in the Russian Federation. Materials and methods: up to September 1, 2020, 10 cases of COVID-19 in CF patients were registered. Results: the incidence of COVID-19 among children and adolescents with CF up to September 1, 2020 was 3,4:1000. Asymptomatic course was noted in 3 children, mild - in 5, moderate - in 2 (20%) with pneumonia. The main symptoms were fiver (60% - 6 children), increased cough - 5 (50%) and fatigue - in 3 children (30%), in 2 patients (20%) abdominal syndrome. All patients received dornase alfa inhalations, two patients received azythromycin for anti-inflammatory purposes and permanent antibacterial therapy. These factors may play a role in the milder course of COVID-19 in children and adolescents with CF. Цель исследования - оценка распространенности и течения COVID-19 у детей и подростков с муковисцидозом (МВ) в России. Материалы и методы исследования: на 1 сентября 2020 г. зарегистрировано 10 случаев заболевания COVID-19 у пациентов с МВ. Результаты: заболеваемость COVID-19 среди детей и подростков с МВ на 1 сентября 2020 г. составила 3,4:1000. Бессимптомное течение отмечено у 3 детей, легкое - у 5, среднетяжелое - у 2 (20%) на фоне пневмонии. Основные симптомы - лихорадка (60% - 6 детей), усиление кашля (50% - 5 детей) и слабость - у 3 детей (30%), у 2 (20%) - абдоминальный синдром. Все пациенты получали ингаляции дорназы-альфа, 2 - азитромицин с противовоспалительной целью и постоянную антибактериальную терапию. Заключение: указанные факторы могут играть роль в более легком течении COVID-19 у детей и подростков с МВ.