ABSTRACT
Objectives: Depression and anxiety in patients with cystic fibrosis (CF) have a negative impact on physical health, therapy adherence, and the quality of life of those affected. At the moment there is hardly any research on the optimal and early treatment of these comorbidities. The COACH project (Chronic Conditions in Adolescents: Implementation and Evaluation of Patient-centered Collaborative Healthcare), funded by the German Federal Ministry of Education and Research, aims to identify psychological stress in chronically ill adolescents at an early stage, to gain a better understanding and optimise treatment. Methods: As part of the COACH project, an anxiety and depression screening tool was implemented in the German CF register Mukoweb. Based on the current international guidelines, the evaluated questionnaires PHQ-9 and GAD-7 are completed once a year in participating German clinics by adolescents with CF aged 12 to 21 years and transferred directly to Mukoweb. Patients are then offered the opportunity to participate in further sub-projects, which are intended to improve depressive and anxiety distress by supporting strengths and strategies in coping with their illness. Results: So far, 7 CF centres are participating in the COACH project. Screening was performed in 96 patients with a median age of 16.6 years, 56.3% of which were female. In 19.8% of the patients screened, the result was in the abnormal range with a screening result of PHQ-9 ≥7 or GAD-7 ≥7 (as of Dec 31, 2020). Due to the COVID-19 pandemic restrictions, recruitment has been very delayed in 2020. Conclusion: The first interim results show that one in five of the adolescents with CF examined suffers from anxiety or depression and the care for these comorbidities is of high relevance. Based on the study results of the COACH project, the aim is to raise awareness of Mental Health Screening and to provide evidence-based recommendations for collaborative care of those affected.
ABSTRACT
Objectives: As the novel coronavirus (SARS-CoV-2) pandemic continues, people with cystic fibrosis (CF) have been identified as being a vulnerable group. It is essential that people with CF, their families and their clinical teams have the most up-to-date information on the impact of SARS-CoV-2 on their health. This study aims to characterise the impact of SARS-CoV-2 infection in people with CF throughout 2020, identify factors that predict clinical progression of COVID-19, and to describe medium-term follow-up of people who have been infected. Methods: The ‘Cystic Fibrosis Registry Global Harmonization Group’ is a worldwide network of CF Registries that each contributed data on people with CF diagnosed with SARS-CoV-2 infection. In this analysis, we will report on cases contributed from 22 countries diagnosed between 1st February and 13th December 2020. We will present demographic, pre-infection clinical characteristics, symptoms, infection management and outcomes. We will use multivariable logistic regression to assess predictors for hospitalisation with respiratory support and intensive care admission as the outcomes of interest representing clinical progression of COVID-19. Descriptive analysis of medium-term follow-up BMI and FEV1% predicted values will also be undertaken. Results: Results pending. Expected cohort size >1,000, including the 181 previously reported in our paper “The global impact of SARS-CoV-2 in 181 people with cystic fibrosis.” Conclusion: It is expected that the findings of this study will have important implications for shielding advice, clinical care and vaccine prioritisation for people with CF.