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Factors associated with clinical progression to severe COVID-19 in people with cystic fibrosis: A global observational study.
Carr, Siobhán B; McClenaghan, Elliot; Elbert, Alexander; Faro, Albert; Cosgriff, Rebecca; Abdrakhmanov, Olzhas; Brownlee, Keith; Burgel, Pierre-Régis; Byrnes, Catherine A; Cheng, Stephanie Y; Colombo, Carla; Corvol, Harriet; Daneau, Géraldine; Goss, Christopher H; Gulmans, Vincent; Gutierrez, Hector; Harutyunyan, Satenik; Helmick, Meagan; Jung, Andreas; Kashirskaya, Nataliya; McKone, Edward; Melo, Joel; Middleton, Peter G; Mondejar-Lopez, Pedro; de Monestrol, Isabelle; Nährlich, Lutz; Padoan, Rita; Parker, Megan; Pastor-Vivero, M Dolores; Rizvi, Samar; Ruseckaite, Rasa; Salvatore, Marco; da Silva-Filho, Luiz Vicente R F; Versmessen, Nick; Zampoli, Marco; Marshall, Bruce C; Stephenson, Anne L.
  • Carr SB; Royal Brompton Hospital, part of GSST NHS Foundation Trust, London, UK; NHLI, Imperial College, London, UK. Electronic address: s.carr@rbht.nhs.uk.
  • McClenaghan E; Cystic Fibrosis Trust, London, UK; London School of Hygiene and Tropical Medicine, London, UK.
  • Elbert A; Cystic Fibrosis Foundation, USA.
  • Faro A; Cystic Fibrosis Foundation, USA.
  • Cosgriff R; Cystic Fibrosis Trust, London, UK.
  • Abdrakhmanov O; The Second Children's Hospital, Kazakhstan.
  • Brownlee K; Cystic Fibrosis Trust, London, UK.
  • Burgel PR; Université de Paris, Inserm U1016, Institut Cochin and Cochin Hospital, Assistance Publique Hôpitaux de Paris (APHP), France.
  • Byrnes CA; Starship Children's Hospital and University of Auckland, Auckland, New Zealand.
  • Cheng SY; Cystic Fibrosis, Canada.
  • Colombo C; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy.
  • Corvol H; Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Paris, France.
  • Daneau G; Sciensano, Belgium.
  • Goss CH; University of Washington, Seattle, USA.
  • Gulmans V; Dutch CF Foundation NCFS, Baarn, Netherlands.
  • Gutierrez H; University of Alabama at Birmingham, Alabama, USA.
  • Harutyunyan S; Yerevan University CF Centre, Muratsan Hospital, Yerevan, Armenia.
  • Helmick M; Cystic Fibrosis Foundation, USA.
  • Jung A; University Children's Hospital, Zurich, Switzerland.
  • Kashirskaya N; Research Centre for Medical Genetics, Russia.
  • McKone E; St Vincent's University Hospital, Dublin, Ireland.
  • Melo J; Instituto Nacional Del Torax, Chile.
  • Middleton PG; Westmead Hospital, Sydney, Australia.
  • Mondejar-Lopez P; Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.
  • de Monestrol I; Department of Pediatrics, CLINTEC, Karolinska Institutet; Karolinska University Hospital Huddinge, Sweden.
  • Nährlich L; Department of Pediatrics, Justus-Liebig-University Giessen, Giessen, Germany.
  • Padoan R; Cystic Fibrosis Support Center, Department of Paediatric, University of Brescia, Italy.
  • Parker M; Cystic Fibrosis, Canada.
  • Pastor-Vivero MD; Hospital Universitario Cruces, IIC Biocruces-Bizkaia, Bizkaia.
  • Rizvi S; Cystic Fibrosis Foundation, USA.
  • Ruseckaite R; Monash University, Melbourne, Australia.
  • Salvatore M; Istituto Superiore di Sanita, National Center Rare Diseases, Undiagnosed Rare Diseases Interdepartmental Unit, Rome, Italy.
  • da Silva-Filho LVRF; Instituto da Criança HCFMUSP, São Paulo, Brazil.
  • Versmessen N; Expert by Experience, Ghent University, Belgium.
  • Zampoli M; University of Cape Town and Red Cross War Memorial Children's Hospital, South Africa.
  • Marshall BC; Cystic Fibrosis Foundation, USA.
  • Stephenson AL; Cystic Fibrosis, Canada; Toronto Adult Cystic Fibrosis Centre, St. Michael's Hospital, Toronto, Canada.
J Cyst Fibros ; 21(4): e221-e231, 2022 07.
Article in English | MEDLINE | ID: covidwho-1885892
ABSTRACT

BACKGROUND:

This international study aimed to characterise the impact of acute SARS-CoV-2 infection in people with cystic fibrosis and investigate factors associated with severe outcomes. Methods Data from 22 countries prior to 13th December 2020 and the introduction of vaccines were included. It was de-identified and included patient demographics, clinical characteristics, treatments, outcomes and sequalae following SARS-CoV-2 infection. Multivariable logistic regression was used to investigate factors associated with clinical progression to severe COVID-19, using the primary outcome of hospitalisation with supplemental oxygen.

RESULTS:

SARS-CoV-2 was reported in 1555 people with CF, 1452 were included in the analysis. One third were aged <18 years, and 9.4% were solid-organ transplant recipients. 74.5% were symptomatic and 22% were admitted to hospital. In the non-transplanted cohort, 39.5% of patients with ppFEV1<40% were hospitalised with oxygen verses 3.2% with ppFEV >70% a 17-fold increase in odds. Worse outcomes were independently associated with older age, non-white race, underweight body mass index, and CF-related diabetes. Prescription of highly effective CFTR modulator therapies was associated with a significantly reduced odds of being hospitalised with oxygen (AOR 0.43 95%CI 0.31-0.60 p<0.001). Transplanted patients were hospitalised with supplemental oxygen therapy (21.9%) more often than non-transplanted (8.8%) and was independently associated with the primary outcome (Adjusted OR 2.45 95%CI 1.27-4.71 p=0.007).

CONCLUSIONS:

This is the first study to show that there is a protective effect from the use of CFTR modulator therapy and that people with CF from an ethnic minority are at more risk of severe infection with SARS-CoV-2.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cystic Fibrosis / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid / Vaccines Limits: Humans Language: English Journal: J Cyst Fibros Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cystic Fibrosis / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid / Vaccines Limits: Humans Language: English Journal: J Cyst Fibros Year: 2022 Document Type: Article