Factors associated with clinical progression to severe COVID-19 in people with cystic fibrosis: A global observational study

• 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. © 2022

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)

Nyckelord

Coronavirus

COVID-19

Cystic fibrosis

SARS-CoV-2

Transplant

cystic fibrosis transmembrane conductance regulator

elexacaftor plus ivacaftor plus tezacaftor

ivacaftor

ivacaftor plus lumacaftor

ivacaftor plus tezacaftor

oxygen

SARS-CoV-2 vaccine

adult

all cause mortality

Article

artificial ventilation

body mass

cohort analysis

controlled study

coronavirus disease 2019

coughing

cystic fibrosis

demographics

disease exacerbation

drug efficacy

dyspnea

extracorporeal oxygenation

fatigue

female

fever

forced expiratory volume

genotype

graft recipient

hospital admission

hospital patient

hospitalization

human

hypertension

intensive care unit

intubation

invasive ventilation

male

myalgia

obesity

observational study

outcome assessment

oxygen therapy

pancreatic insufficiency

prescription

Pseudomonas aeruginosa

Pseudomonas infection

race

Severe acute respiratory syndrome coronavirus 2

underweight

complication

ethnicity

minority group

Cystic Fibrosis

Cystic Fibrosis Transmembrane Conductance Regulator

Ethnicity

Humans

Minority Groups

Oxygen

Publikations- och innehållstyp

art (ämneskategori)

ref (ämneskategori)