tetano
Editor, Senior Moderator
J Cyst Fibros
. 2022 Jun 13;S1569-1993(22)00593-8.
doi: 10.1016/j.jcf.2022.06.006. Online ahead of print.
Factors associated with clinical progression to severe COVID-19 in people with cystic fibrosis: A global observational study
Siobhán B Carr[SUP] 1 [/SUP], Elliot McClenaghan[SUP] 2 [/SUP], Alexander Elbert[SUP] 3 [/SUP], Albert Faro[SUP] 3 [/SUP], Rebecca Cosgriff[SUP] 4 [/SUP], Olzhas Abdrakhmanov[SUP] 5 [/SUP], Keith Brownlee[SUP] 4 [/SUP], Pierre-Régis Burgel[SUP] 6 [/SUP], Catherine A Byrnes[SUP] 7 [/SUP], Stephanie Y Cheng[SUP] 8 [/SUP], Carla Colombo[SUP] 9 [/SUP], Harriet Corvol[SUP] 10 [/SUP], Géraldine Daneau[SUP] 11 [/SUP], Christopher H Goss[SUP] 12 [/SUP], Vincent Gulmans[SUP] 13 [/SUP], Hector Gutierrez[SUP] 14 [/SUP], Satenik Harutyunyan[SUP] 15 [/SUP], Meagan Helmick[SUP] 3 [/SUP], Andreas Jung[SUP] 16 [/SUP], Nataliya Kashirskaya[SUP] 17 [/SUP], Edward McKone[SUP] 18 [/SUP], Joel Melo[SUP] 19 [/SUP], Peter G Middleton[SUP] 20 [/SUP], Pedro Mondejar-Lopez[SUP] 21 [/SUP], Isabelle de Monestrol[SUP] 22 [/SUP], Lutz Nährlich[SUP] 23 [/SUP], Rita Padoan[SUP] 24 [/SUP], Megan Parker[SUP] 8 [/SUP], M Dolores Pastor-Vivero[SUP] 25 [/SUP], Samar Rizvi[SUP] 3 [/SUP], Rasa Ruseckaite[SUP] 26 [/SUP], Marco Salvatore[SUP] 27 [/SUP], Luiz Vicente R F da Silva-Filho[SUP] 28 [/SUP], Nick Versmessen[SUP] 29 [/SUP], Marco Zampoli[SUP] 30 [/SUP], Bruce C Marshall[SUP] 3 [/SUP], Anne L Stephenson[SUP] 31 [/SUP], CF Registry Global Collaboration
Affiliations
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 13[SUP]th[/SUP] 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.
Keywords: COVID-19; Coronavirus; Cystic fibrosis; SARS-CoV-2; Transplant.
. 2022 Jun 13;S1569-1993(22)00593-8.
doi: 10.1016/j.jcf.2022.06.006. Online ahead of print.
Factors associated with clinical progression to severe COVID-19 in people with cystic fibrosis: A global observational study
Siobhán B Carr[SUP] 1 [/SUP], Elliot McClenaghan[SUP] 2 [/SUP], Alexander Elbert[SUP] 3 [/SUP], Albert Faro[SUP] 3 [/SUP], Rebecca Cosgriff[SUP] 4 [/SUP], Olzhas Abdrakhmanov[SUP] 5 [/SUP], Keith Brownlee[SUP] 4 [/SUP], Pierre-Régis Burgel[SUP] 6 [/SUP], Catherine A Byrnes[SUP] 7 [/SUP], Stephanie Y Cheng[SUP] 8 [/SUP], Carla Colombo[SUP] 9 [/SUP], Harriet Corvol[SUP] 10 [/SUP], Géraldine Daneau[SUP] 11 [/SUP], Christopher H Goss[SUP] 12 [/SUP], Vincent Gulmans[SUP] 13 [/SUP], Hector Gutierrez[SUP] 14 [/SUP], Satenik Harutyunyan[SUP] 15 [/SUP], Meagan Helmick[SUP] 3 [/SUP], Andreas Jung[SUP] 16 [/SUP], Nataliya Kashirskaya[SUP] 17 [/SUP], Edward McKone[SUP] 18 [/SUP], Joel Melo[SUP] 19 [/SUP], Peter G Middleton[SUP] 20 [/SUP], Pedro Mondejar-Lopez[SUP] 21 [/SUP], Isabelle de Monestrol[SUP] 22 [/SUP], Lutz Nährlich[SUP] 23 [/SUP], Rita Padoan[SUP] 24 [/SUP], Megan Parker[SUP] 8 [/SUP], M Dolores Pastor-Vivero[SUP] 25 [/SUP], Samar Rizvi[SUP] 3 [/SUP], Rasa Ruseckaite[SUP] 26 [/SUP], Marco Salvatore[SUP] 27 [/SUP], Luiz Vicente R F da Silva-Filho[SUP] 28 [/SUP], Nick Versmessen[SUP] 29 [/SUP], Marco Zampoli[SUP] 30 [/SUP], Bruce C Marshall[SUP] 3 [/SUP], Anne L Stephenson[SUP] 31 [/SUP], CF Registry Global Collaboration
Affiliations
- PMID: 35753987
- DOI: 10.1016/j.jcf.2022.06.006
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 13[SUP]th[/SUP] 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.
Keywords: COVID-19; Coronavirus; Cystic fibrosis; SARS-CoV-2; Transplant.