Background: SARS-Co-V-2 infection in people with CF (pwCF) can lead to severe outcomes. Methods: In this observational study, the European Cystic Fibrosis Society Patient Registry collected data on pwCF and SARS-CoV-2 infection to estimate incidence, describe clinical presentation and investigate factors associated with severe outcomes using multivariable analysis. Results: Up to 31 December 2020, 26 countries reported information on 828 pwCF and SARS-CoV-2 infection. Incidence was 17.2 per 1000 pwCF (95% CI: 16.0-18.4). Median age was 24 years, 48.4% were male and 9.4% had lung transplants. SARS-CoV-2 incidence was higher in lung-transplanted (28.6 [95% CI: 22.7–35.5]) versus non-lung transplanted pwCF (16.6 [95% CI: 15.4–17.8]) (p=<0.001). SARS-CoV-2 infection caused symptomatic illness in 75.7%. Factors associated with symptomatic SARS-CoV-2 infection were age >40 years, at least one F508del mutation, and pancreatic insufficiency. Overall, 23.7% were admitted to hospital, 2.5% to intensive care. Regretfully 11 pwCF (1.4%) died. Hospitalisation, oxygen therapy, intensive care, respiratory support and death were 2-6-fold more frequent in lung-transplanted versus non-lung transplanted pwCF. Factors associated with hospitalisation and oxygen therapy were lung transplantation, CF-related diabetes (CFRD), moderate or severe lung disease and azithromycin use (often considered a surrogate marker for Pseudomonas aeruginosa infection and poorer lung function). Conclusion: SARS-CoV-2 infection yielded high morbidity and hospitalisation in pwCF. PwCF with forced expiratory volume in one second (FEV1) <70% predicted, CFRD and those with lung transplants are at particular risk of more severe outcomes.

Factors for severe outcomes following SARS-CoV-2 infection in people with cystic fibrosis in Europe / A. Jung, A. Orenti, F. Dunlevy, E. Aleksejeva, E. Bakkeheim, V. Bobrovnichy, S.B. Carr, C. Colombo, H. Corvol, R. Cosgriff, G. Daneau, D. Dogru, P. Drevinek, A. Dugac Vukic, I. Fajac, A. Fox, S. Fustik, V. Gulmans, S. Harutyunyan, E. Hatziagorou, I. Kasmi, H. Kayserová, E. Kondratyeva, U. Krivec, H. Makukh, K. Malakauskas, E.F. Mckone, M. Mei-Zahav, I. de Monestrol, H. Vebert Olesen, R. Padoan, T. Parulava, M. Dolores Pastor-Vivero, L. Pereira, G. Petrova, A. Pfleger, L. Pop, J.G. van Rens, M. Rodić, M. Schlesser, V. Storms, O. Turcu, L. Woźniacki, P. Yiallouros, A. Zolin, D.G. Downey, L. Naehrlich. - In: ERJ OPEN RESEARCH. - ISSN 2312-0541. - 7:4(2021), pp. 00411-2021.1-00411-2021.18. [10.1183/23120541.00411-2021]

Factors for severe outcomes following SARS-CoV-2 infection in people with cystic fibrosis in Europe

A. Orenti
Co-primo
;
C. Colombo;A. Zolin;
2021

Abstract

Background: SARS-Co-V-2 infection in people with CF (pwCF) can lead to severe outcomes. Methods: In this observational study, the European Cystic Fibrosis Society Patient Registry collected data on pwCF and SARS-CoV-2 infection to estimate incidence, describe clinical presentation and investigate factors associated with severe outcomes using multivariable analysis. Results: Up to 31 December 2020, 26 countries reported information on 828 pwCF and SARS-CoV-2 infection. Incidence was 17.2 per 1000 pwCF (95% CI: 16.0-18.4). Median age was 24 years, 48.4% were male and 9.4% had lung transplants. SARS-CoV-2 incidence was higher in lung-transplanted (28.6 [95% CI: 22.7–35.5]) versus non-lung transplanted pwCF (16.6 [95% CI: 15.4–17.8]) (p=<0.001). SARS-CoV-2 infection caused symptomatic illness in 75.7%. Factors associated with symptomatic SARS-CoV-2 infection were age >40 years, at least one F508del mutation, and pancreatic insufficiency. Overall, 23.7% were admitted to hospital, 2.5% to intensive care. Regretfully 11 pwCF (1.4%) died. Hospitalisation, oxygen therapy, intensive care, respiratory support and death were 2-6-fold more frequent in lung-transplanted versus non-lung transplanted pwCF. Factors associated with hospitalisation and oxygen therapy were lung transplantation, CF-related diabetes (CFRD), moderate or severe lung disease and azithromycin use (often considered a surrogate marker for Pseudomonas aeruginosa infection and poorer lung function). Conclusion: SARS-CoV-2 infection yielded high morbidity and hospitalisation in pwCF. PwCF with forced expiratory volume in one second (FEV1) <70% predicted, CFRD and those with lung transplants are at particular risk of more severe outcomes.
Cystic fibrosis; SARS-CoV-2; risk factors; observational; Covid-19
Settore MED/01 - Statistica Medica
Settore MED/10 - Malattie dell'Apparato Respiratorio
Settore MED/38 - Pediatria Generale e Specialistica
27-dic-2021
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/888838
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