tetano
Editor, Senior Moderator
ERJ Open Res
. 2021 Dec 27;7(4):00411-2021.
doi: 10.1183/23120541.00411-2021. eCollection 2021 Oct.
Factors for severe outcomes following SARS-CoV-2 infection in people with cystic fibrosis in Europe
Andreas Jung[SUP] 1 2 [/SUP], Annalisa Orenti[SUP] 3 2 [/SUP], Fiona Dunlevy[SUP] 4 2 [/SUP], Elina Aleksejeva[SUP] 5 [/SUP], Egil Bakkeheim[SUP] 6 [/SUP], Vladimir Bobrovnichy[SUP] 7 [/SUP], Siobhán B Carr[SUP] 8 9 [/SUP], Carla Colombo[SUP] 10 [/SUP], Harriet Corvol[SUP] 11 [/SUP], Rebecca Cosgriff[SUP] 12 [/SUP], Géraldine Daneau[SUP] 13 [/SUP], Deniz Dogru[SUP] 14 [/SUP], Pavel Drevinek[SUP] 15 [/SUP], Andrea Dugac Vukic[SUP] 16 [/SUP], Isabelle Fajac[SUP] 17 18 [/SUP], Alice Fox[SUP] 4 [/SUP], Stojka Fustik[SUP] 19 [/SUP], Vincent Gulmans[SUP] 20 [/SUP], Satenik Harutyunyan[SUP] 21 [/SUP], Elpis Hatziagorou[SUP] 22 [/SUP], Irena Kasmi[SUP] 23 [/SUP], Hana Kayserová[SUP] 24 [/SUP], Elena Kondratyeva[SUP] 25 [/SUP], Uroš Krivec[SUP] 26 [/SUP], Halyna Makukh[SUP] 27 [/SUP], Kestutis Malakauskas[SUP] 28 [/SUP], Edward F McKone[SUP] 29 [/SUP], Meir Mei-Zahav[SUP] 30 31 [/SUP], Isabelle de Monestrol[SUP] 32 [/SUP], Hanne Vebert Olesen[SUP] 33 [/SUP], Rita Padoan[SUP] 34 35 [/SUP], Tsitsino Parulava[SUP] 36 [/SUP], Maria Dolores Pastor-Vivero[SUP] 37 [/SUP], Luísa Pereira[SUP] 38 [/SUP], Guergana Petrova[SUP] 39 [/SUP], Andreas Pfleger[SUP] 40 [/SUP], Liviu Pop[SUP] 41 [/SUP], Jacqui G van Rens[SUP] 4 [/SUP], Milan Rodic[SUP] 42 [/SUP], Marc Schlesser[SUP] 43 [/SUP], Valérie Storms[SUP] 44 [/SUP], Oxana Turcu[SUP] 45 [/SUP], Lukasz Woz Niacki[SUP] 46 [/SUP], Panayiotis Yiallouros[SUP] 47 [/SUP], Anna Zolin[SUP] 3 [/SUP], Damian G Downey[SUP] 48 49 50 [/SUP], Lutz Naehrlich[SUP] 3 51 50 [/SUP]
Affiliations
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in people with cystic fibrosis (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 December 31, 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% of pwCF were admitted to hospital, 2.5% of those to intensive care, and regretfully 11 (1.4%) died. Hospitalisation, oxygen therapy, intensive care, respiratory support and death were 2- to 6-fold more frequent in lung-transplanted versus non-lung-transplanted pwCF.Factors associated with hospitalisation and oxygen therapy were lung transplantation, cystic fibrosis-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 1 s <70% predicted, CFRD and those with lung transplants are at particular risk of more severe outcomes.
. 2021 Dec 27;7(4):00411-2021.
doi: 10.1183/23120541.00411-2021. eCollection 2021 Oct.
Factors for severe outcomes following SARS-CoV-2 infection in people with cystic fibrosis in Europe
Andreas Jung[SUP] 1 2 [/SUP], Annalisa Orenti[SUP] 3 2 [/SUP], Fiona Dunlevy[SUP] 4 2 [/SUP], Elina Aleksejeva[SUP] 5 [/SUP], Egil Bakkeheim[SUP] 6 [/SUP], Vladimir Bobrovnichy[SUP] 7 [/SUP], Siobhán B Carr[SUP] 8 9 [/SUP], Carla Colombo[SUP] 10 [/SUP], Harriet Corvol[SUP] 11 [/SUP], Rebecca Cosgriff[SUP] 12 [/SUP], Géraldine Daneau[SUP] 13 [/SUP], Deniz Dogru[SUP] 14 [/SUP], Pavel Drevinek[SUP] 15 [/SUP], Andrea Dugac Vukic[SUP] 16 [/SUP], Isabelle Fajac[SUP] 17 18 [/SUP], Alice Fox[SUP] 4 [/SUP], Stojka Fustik[SUP] 19 [/SUP], Vincent Gulmans[SUP] 20 [/SUP], Satenik Harutyunyan[SUP] 21 [/SUP], Elpis Hatziagorou[SUP] 22 [/SUP], Irena Kasmi[SUP] 23 [/SUP], Hana Kayserová[SUP] 24 [/SUP], Elena Kondratyeva[SUP] 25 [/SUP], Uroš Krivec[SUP] 26 [/SUP], Halyna Makukh[SUP] 27 [/SUP], Kestutis Malakauskas[SUP] 28 [/SUP], Edward F McKone[SUP] 29 [/SUP], Meir Mei-Zahav[SUP] 30 31 [/SUP], Isabelle de Monestrol[SUP] 32 [/SUP], Hanne Vebert Olesen[SUP] 33 [/SUP], Rita Padoan[SUP] 34 35 [/SUP], Tsitsino Parulava[SUP] 36 [/SUP], Maria Dolores Pastor-Vivero[SUP] 37 [/SUP], Luísa Pereira[SUP] 38 [/SUP], Guergana Petrova[SUP] 39 [/SUP], Andreas Pfleger[SUP] 40 [/SUP], Liviu Pop[SUP] 41 [/SUP], Jacqui G van Rens[SUP] 4 [/SUP], Milan Rodic[SUP] 42 [/SUP], Marc Schlesser[SUP] 43 [/SUP], Valérie Storms[SUP] 44 [/SUP], Oxana Turcu[SUP] 45 [/SUP], Lukasz Woz Niacki[SUP] 46 [/SUP], Panayiotis Yiallouros[SUP] 47 [/SUP], Anna Zolin[SUP] 3 [/SUP], Damian G Downey[SUP] 48 49 50 [/SUP], Lutz Naehrlich[SUP] 3 51 50 [/SUP]
Affiliations
- PMID: 34984210
- PMCID: PMC8557394
- DOI: 10.1183/23120541.00411-2021
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in people with cystic fibrosis (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 December 31, 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% of pwCF were admitted to hospital, 2.5% of those to intensive care, and regretfully 11 (1.4%) died. Hospitalisation, oxygen therapy, intensive care, respiratory support and death were 2- to 6-fold more frequent in lung-transplanted versus non-lung-transplanted pwCF.Factors associated with hospitalisation and oxygen therapy were lung transplantation, cystic fibrosis-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 1 s <70% predicted, CFRD and those with lung transplants are at particular risk of more severe outcomes.