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


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.

SUBMITTER: Carr SB 

PROVIDER: S-EPMC9189103 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

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

Carr Siobhán B SB   McClenaghan Elliot E   Elbert Alexander A   Faro Albert A   Cosgriff Rebecca R   Abdrakhmanov Olzhas O   Brownlee Keith K   Burgel Pierre-Régis PR   Byrnes Catherine A CA   Cheng Stephanie Y SY   Colombo Carla C   Corvol Harriet H   Daneau Géraldine G   Goss Christopher H CH   Gulmans Vincent V   Gutierrez Hector H   Harutyunyan Satenik S   Helmick Meagan M   Jung Andreas A   Kashirskaya Nataliya N   McKone Edward E   Melo Joel J   Middleton Peter G PG   Mondejar-Lopez Pedro P   de Monestrol Isabelle I   Nährlich Lutz L   Padoan Rita R   Parker Megan M   Pastor-Vivero M Dolores MD   Rizvi Samar S   Ruseckaite Rasa R   Salvatore Marco M   da Silva-Filho Luiz Vicente R F LVRF   Versmessen Nick N   Zampoli Marco M   Marshall Bruce C BC   Stephenson Anne L AL  

Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society 20220613 4


<h4>Background</h4>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 u  ...[more]

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