A review of paediatric cystic fibrosis care during the COVID-19 pandemic

ABSTRACT

Objective: To explore the impact of COVID-19 on paediatric cystic fibrosis (CF) patient care.Method: A retrospective review of data on 20 CF patients between 1March - 30 November 2020 compared to data from 1 March - 30 November2019. This included courses of oral antibiotics;days requiring intravenousantibiotics (IVAB);routine IVAB;home IVAB;face-to-face/phone appointments;acute hospital presentations;and microbiology samples.Results: In 2020 the number of courses of oral antibiotics for exacerbationsor bacteria growth decreased from 29 to 14;total IVAB days decreased from177 days to 107. 2 courses of routine IVAB were cancelled and 1 coursewaspostponed, home IVAB decreased from 125 days to 85 due to reducedaseptic IV services. Face-to-face appointments decreased from 76 appointmentsto 15. In 2019 no phone appointments were completed;in 2020there were 51. 10 patients presented to Paediatric Observation andAssessment Unit in 2019;this halved to 5 in 2020. Microbiology samplesnearly halved from 276 to 141 samples.Conclusion: Oral antibiotic courses, IVAB therapy and acute hospitaladmissionswere reduced in 2020. This could be due to a number of reasonssuch as shielding, closure of the paediatric unit to house adult patients,reduced aseptic IV services, family reluctance to access care at a differenthospital or being hesitant to present to hospital due to increased infectionrisk. Microbiology samples are less practical to collect due to reduced faceto-face contacts. Some families may be apprehensive to drop samples at thehospital due to potential exposure to COVID-19. In 2020, most appointmentswerevia phone;this is a change from 2019. Due to the increased riskof cross-infection for CF patients, limiting hospital attendance is a majorstep in the right direction to improve care. Although changes can bebeneficial, it is important to recognise the limitations of reduced face-tofacepatient contact and consider family preferences of care delivery