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Factors associated with clinical progression to severe COVID-19 in people with cystic fibrosis: A global observational study
Journal of cystic fibrosis, 2022-07, Vol.21 (4), p.e221-e231
2022

Details

Autor(en) / Beteiligte
Titel
Factors associated with clinical progression to severe COVID-19 in people with cystic fibrosis: A global observational study
Ist Teil von
  • Journal of cystic fibrosis, 2022-07, Vol.21 (4), p.e221-e231
Ort / Verlag
Netherlands: Elsevier B.V
Erscheinungsjahr
2022
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
  • 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. 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). 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.
Sprache
Englisch
Identifikatoren
ISSN: 1569-1993, 1873-5010
eISSN: 1873-5010
DOI: 10.1016/j.jcf.2022.06.006
Titel-ID: cdi_swepub_primary_oai_prod_swepub_kib_ki_se_150748769
Format
–
Schlagworte
adult, all cause mortality, Allmänmedicin, artificial ventilation, body mass, Clinical Medicine, cohort analysis, complication, controlled study, Coronavirus, coronavirus disease 2019, coughing, COVID-19, COVID-19 - epidemiology, COVID-19 - therapy, Cystic fibrosis, Cystic Fibrosis - complications, Cystic Fibrosis - epidemiology, Cystic Fibrosis - therapy, Cystic Fibrosis Transmembrane Conductance Regulator, demographics, disease exacerbation, drug efficacy, dyspnea, elexacaftor plus ivacaftor plus tezacaftor, Ethnicity, extracorporeal oxygenation, Family Medicine, fatigue, female, fever, forced expiratory volume, genotype, graft recipient, hospital admission, hospital patient, hospitalization, human, Humans, hypertension, intensive care unit, intubation, invasive ventilation, ivacaftor, ivacaftor plus lumacaftor, ivacaftor plus tezacaftor, Klinisk medicin, Life Sciences, male, Medical and Health Sciences, Medicin och hälsovetenskap, minority group, Minority Groups, myalgia, obesity, observational study, Original, outcome assessment, Oxygen, oxygen therapy, pancreatic insufficiency, prescription, Pseudomonas aeruginosa, Pseudomonas infection, race, SARS-CoV-2, SARS-CoV-2 vaccine, Severe acute respiratory syndrome coronavirus 2, Transplant, underweight

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