ABSTRACT
Objectives: The COVID-19 pandemic has a substantial impact on the functioning of the entire society. Cystic fibrosis (CF) is an additional factorinfluencing mental health during this unpredictable time. In the Warsawpaediatric CF centre, increased level of stress, anxiety and more depressivesymptoms were observed in patients with CF and their parents. Over time,more children required psychiatric consultations and some of them wereprescribed pharmacological treatment. In many families, conflicts aroseand the financial situation deteriorated. There were no formal guidelineson psychological care during a pandemic. Active participation in Europeangroups of specialists working with patients with CF, such as the ECFSEuropean Psychosocial Special Interest Group and ECFS Mental HealthWorking Group, allowed us share experiences and practices with other CFcentres and implement new ideas in our centre.Results: Different actions and interventions were undertaken bypsychologists:1. Support and psychoeducation for children with CF and their families:• Communication by the special internal social media forum (onlyfor members), for example newsletters and posts. Mutual supportof parents and patients,• The additional possibility of consultation by phone, e-mail oronline,• An online support group for parents moderated by a psychologistorganised at the request of the parents,• Lecture on anxiety and coping with stress at a national onlineworkshop for parents and adults with CF 2. Individual help and support for the multidisciplinary team (MDT)members3. Lectures on the impact of epidemics on mental functioning andcoping at Polish conferences for CF specialists.Conclusion: The COVID-19 pandemic is still ongoing. All MDT members,including psychologists, have more knowledge and experience in caring forpatients with CF and their families. However, long-term psychologicaleffects are difficult to predict and require our attention
ABSTRACT
Background: The global COVID-19 pandemic has changed daily life, due to restrictions affecting day-to-day functioning. The strict lockdown changed habits of cystic fibrosis (CF) patients as well. The aim of our study was to evaluate the impact of the one-month strict spring lockdown in Poland on the nutritional status and body composition of CF paediatric patients. Methods: All CF patients between 8 and 18 years old who had both in- and outpatient visits with completed data at the Cystic Fibrosis Centre in Warsaw were included in the study. BMI z-scores (CDC calculator), as well as the fat free mass index (FFMI) and the fat mass index (FMI) were calculated according to the following formulas: FFMI = FFM/height2, FMI = FM/height2. The strict lockdown (SL) in Poland was between 16.03.20 and 20.04.20. The measures were evaluated on average: 3 months before SL (M1);3 months after SL (M2), and 3 months after M2 (M3). Results: 101 CF subjects (51% female), with a mean age of 11.53 ± 3.29 years were assessed. 48% of them were heterozygotes F508del and 80% had pancreatic insufficiency. The highest significant increase in values of BMI z-score and FMI was observed after SL (M2) with decrease in M3 (F = 7.18;p = 0.001;F = 4.71;p = 0.01, respectively). FFMI increased significantly and continually from M1 to M3 (F = 14.17;p < 0.001). The mean values for BMI z-score, FMI and FFMI were, respectively, as follows: M1: [–0.20 ± 0.86;4.00 ± 1.51;13.81 ± 1.86];M2: [–0.05 ± 0.82;4.19 ± 1.54;14.05 ± 1.91];M3: [–0.14 ± 0.84;4.07 ± 1.46;14.17 ± 1.91]. The mean 3 months differences between measures [M2 vs M1] and [M3 vs M2] were negative for BMI z-score [–0.17 ± 0.49;p = 0.005];FMI [–0.21 ± 0.77;p = 0.006];FFMI [–0.07 ± 1.15;p = 0.56]. Conclusion: CF paediatric patients improved nutritional status after strict lockdown with increase both FMI and FFMI, nevertheless a decline with time was observed in BMI z-scores and FMI, but not for FFMI.