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

COVID-19 / epidemiology Cystic Fibrosis / complications Cystic Fibrosis Transmembrane Conductance Regulator Ethnicity Humans Minority Groups Oxygen SARS-CoV-2

COVID-19 Coronavirus Cystic fibrosis SARS-CoV-2 Transplant

Journal

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

ISSN: 1873-5010

Titre abrégé: J Cyst Fibros

Pays: Netherlands

ID NLM: 101128966

Informations de publication

Date de publication:
07 2022

Historique:

received: 01 03 2022

revised: 19 05 2022

accepted: 11 06 2022

pubmed: 27 6 2022

medline: 28 7 2022

entrez: 26 6 2022

Statut: ppublish

Résumé

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 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.

Sections du résumé

BACKGROUND

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.

Identifiants

DOI: 10.1016/j.jcf.2022.06.006 PMID: 35753987 PMC: PMC9189103

pubmed: 35753987

pii: S1569-1993(22)00593-8

doi: 10.1016/j.jcf.2022.06.006

pmc: PMC9189103

pii:

doi:

Substances chimiques

Cystic Fibrosis Transmembrane Conductance Regulator 126880-72-6

Oxygen S88TT14065

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

e221-e231

Subventions

Organisme : CIHR

Pays : Canada

Investigateurs

Scott C Bell (SC)

David Reid (D)

Peter Wark (P)

Eva Van Braeckel (E)

Sophie Gohy (S)

Christiane Knoop (C)

Jessica Pirson (J)

Elke De Wachter (E)

Lieven Dupont (L)

Laurence Hanssens (L)

Vicky Nowé (V)

Monique Lequesne (M)

Rodrigo A Athanazio (RA)

Daniela G Meneses (DG)

Véronique Boussaud (V)

Graziella Brinchault (G)

Emmanuelle Coirier-Duet (E)

Jean-Christophe Dubus (JC)

Dominique Grenet (D)

Sandra de Miranda (S)

Laurence Beaumont (L)

Reem Kanaan (R)

Muriel Lauraens (M)

Clémence Martin (C)

Marie Mittaine (M)

Anne Prévotat (A)

Martine Reynaud-Gaubert (M)

Isabelle Sermet-Gaudelus (I)

Aurelie Tatopoulos (A)

Raphael Chiron (R)

Marie-Laure Dalphin (ML)

Michele Gerardin (M)

Laurence Weiss (L)

Nathalie Wizla (N)

Sophie Ramel (S)

Barry Plant (B)

Cedric Gunaratnam (C)

Abaigeal Jackson (A)

Karin de Winter-de Groot (K)

Bart Luijk (B)

Geertjan Wesseling (G)

Elena Kondratyeva (E)

Elena Zhekayte (E)

Elena Amelina (E)

Mariya Mukhina (M)

Olga Simonova (O)

Antonio Alvarez-Fernandez (A)

Amparo Sole-Jover (A)

Isidoro Cortell-Aznar (I)

Rosa Girón-Moreno (R)

Alejandro López-Neyra (A)

Isabel Ramos-Cancelo (I)

Maite Lázaro-Carrasco (M)

Dolores Pastor Vivero (DP)

Marta Ruiz de Valbuena (MR)

Concepción Prados-Sanchez (C)

Jordi Costa-Colomer (J)

Silvia Gartner (S)

Layla Diab-Caceres (L)

Marita Gilljam (M)

Ulrika Lindberg (U)

Stefanie Diemer (S)

Mark Allenby (M)

Stephen J Bourke (SJ)

Susan C Charman (SC)

Janet Collinson (J)

Owen Dempsey (O)

Sarah Denniston (S)

Maya Desai (M)

Jamie Duckers (J)

Christine Etherington (C)

Elaine Gunn (E)

Alex Higton (A)

Timothy Ho (T)

Jeremy Hull (J)

Andrew Jones (A)

Robert Ian Ketchell (RI)

Susan L Madge (SL)

Anirban Maitra (A)

Ghulam Mujtaba (G)

Edward Nash (E)

Dilip Nazareth (D)

Christopher O'Brien (C)

Claire Onyon (C)

Christopher Orchard (C)

Daniel Peckham (D)

Helen Rodgers (H)

Nadia Shafi (N)

Nicholas Simmonds (N)

Kevin Southern (K)

Martin Walshaw (M)

Danie Watson (D)

Joanna L Whitehouse (JL)

Informations de copyright

Déclaration de conflit d'intérêts

COI Statement All authors declare no conflicts of interest in relationship to this work. Outside of this work the following authors declare payments or honoraria to them or their institution for a combination of lectures, presentations, educational events, advisory boards, steering groups, grants or consultancy fees: SC-Vertex, Chiesi, Profile, Zambon. RC- Vertex, P-RB – Astra-Zeneca, Boehringer Ingelheim, GSK, Insmed, Chiesi, Pfizer, Vertex, Zambon. I deM – Vertex,LN – Vertex, Boehringer,LVS-F – Vertex, AS -Vertex.