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European Respiratory Journal Conference: European Respiratory Society International Congress, ERS ; 60(Supplement 66), 2022.
Article in English | EMBASE | ID: covidwho-2277501


Introduction: Cystic Fibrosis (CF) centers globally increased the number of telehealth clinics during the Covid-19 pandemic and developed processes utilizing telemedicine to replace a standard clinic visit. Whether these new approaches provide an opportunity to improve patients' clinical condition need further investigations. Aims and objectives: To assess the short-term clinical impact of using the NuvoAir Home platform to monitor children and adolescents with CF at home for six months as part of a virtual model of care. Method(s): The NuvoAir Home platform consists of a smartphone application, Bluetooth spirometer and clinician portal. Patients and/or parents were trained to use the platform and asked to do home spirometry monthly. Cystic Fibrosis Questionnaire-Revised (CFQ-R) was collected at the time of study entry and after six months. We calculated the percentage of change between "pre" and "post" conditions of the variables. Result(s): Sixteen children and adolescent CF patients from Federico II Hospital, Naples, Italy (9 females;mean age 16.3+/-0.9;5 homozygous for delta F508;FEV1 79.5+/-26.2 % predicted;FVC 91.6+/-23.6 % predicted;BMI 21.5+/-3.8) were recruited from June 2021. All patients had completed six months follow-up. CFQ-R revealed higher scores indicating a higher patient-reported quality of life with regard to "health perception" + 3%, "social limitations" + 11%, "digestive symptoms" + 6%. We observed a 2 % improvement from baseline in FEV1 % predicted. There was no difference in pulmonary exacerbation versus the previous year. No changes of medical treatment were reported during that time. Conclusion(s): Digital technology for home monitoring in children and adolescents with cystic fibrosis led to improved quality of life and lung function.

Journal of Cystic Fibrosis ; 21(Supplement 2):S79-S80, 2022.
Article in English | EMBASE | ID: covidwho-2114084


Background: Health professionals have explored and tested the use of digital technologies provide in managing chronic respiratory diseases remotely during the COVID-19 pandemic. Further investigation into whether these new approaches to care delivery provide an opportunity to improve cystic fibrosis (CF) management is needed. The aim of this study was to assess the long-term clinical impact of use of e-health as part of a virtual model of care in CF. Method(s): The NuvoAir Home platform consists of a smartphone application, Bluetooth spirometer, and clinician portal. Patients were trained to use the platform and asked to perform home spirometry monthly. Data on pulmonary function and pulmonary exacerbations were collected at baseline and after 12 months. A surveywas emailed to evaluate patients' experience using the technology. Result(s): A cohort of 43 people with CFwere recruited (26 female;mean age 31.6 +/- 6.8;16 homozygous for delta F508;FEV1 48.4 +/- 16.3% predicted). Sustained improvement in forced expiratory volume in 1 second (FEV1) expressed as absolute and percentage predicted was seen through 12 months (mean absolute change 100 mL, p = 0.02;mean percentage predicted change 3.8%, p = 0.005). We found significant improvement in forced vital capacity expressed as absolute value (mean change 230 mL, p = 0.006) and percentage predicted (mean change 6.2%, p = 0.002). The average of number of exacerbations per person 1 year before use of digital technology was 0.84, vs 0.09 1 year after ( p < 0.001). Ninety percent of patients reported that they understood their CF better after starting the virtual care service. No changes in medical treatmentwere reported during that time. Conclusion(s): Use of digital technologies in the management of adults with CF improved lung function and decreased pulmonary exacerbations. People with CF readily accepted using a virtual model of care and improved their understanding of their medical condition. Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

researchsquare; 2020.


Background: Pregnant women are susceptible to the novel coronavirus (SARS-CoV-2) and the consequences on the fetus are still uncertain. Here, we present a case of a pregnant woman with subclinical hypothyroidism and PAI-1 4G/5G mutation who was infected with SARS-CoV-2 at the end of the third trimester of pregnancy. Methods: nested PCR were performed to detect the virus, followed by ssDNA sequencing. Results: transplacental transmission of SARS-CoV-2 can cause placental inflammation, ischemia and neonatal viremia, with complications such as preterm labor and damage to the placental barrier in patients with PAI-1 4G/5G mutation. Conclusion: we show the possibility of transplacental transmission of SARS-CoV-2 infection during the last weeks of pregnancy.

Ischemia , Viremia , Hypothyroidism , COVID-19 , Inflammation , Obstetric Labor, Premature