Clinical course and risk factors for severe COVID-19 among Italian patients with cystic fibrosis: a study within the Italian Cystic Fibrosis Society

• Published in: Infection Vol. 50; no. 3; pp. 671 - 679
• Main Authors: Colombo, Carla, Cipolli, Marco, Daccò, Valeria, Medino, Paola, Alghisi, Federico, Ambroni, Maura, Badolato, Raffaele, Battistini, Fiorella, Bignamini, Elisabetta, Casciaro, Rosaria, Ciciriello, Fabiana, Collura, Mirella, Comello, Isabella, Francalanci, Michela, Ficili, Francesca, Folino, Anna, Leonardi, Salvatore, Leonetti, Giuseppina, Lucanto, Maria Cristina, Lucca, Francesca, Maschio, Massimo, Mencarini, Valeria, Messore, Barbara, Pisi, Giovanna, Pizzamiglio, Giovanna, Poli, Piercarlo, Raia, Valeria, Riberi, Luca, Ros, Mirco, Rotolo, Novella, Sepe, Angela, Taccetti, Giovanni, Vitullo, Pamela, Alicandro, Gianfranco
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2022; Springer Nature B.V
• Subjects: Coronaviruses; COVID-19; Cystic fibrosis; Diabetes mellitus; Family Medicine; General Practice; Infectious Diseases; Internal Medicine; Liver diseases; Medicine; Medicine & Public Health; Original Paper; Pancreas; Patients; Regression analysis; Regression models; Respiratory function; Risk analysis; Risk factors; Risk management; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Transplantation; Underweight; Viral diseases; COVID-19; Cystic fibrosis; Pandemic; SARS-CoV-2
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-021-01737-z

Purpose
To describe the clinical course of COVID-19 in patients with cystic fibrosis (CF) and to identify risk factors for severe COVID-19.
Methods
We conducted a prospective study within the Italian CF Society. CF centers collected baseline and follow-up data of patients with virologically confirmed SARS-CoV-2 infection between March 2020 and June 2021. Odds ratios (ORs) for severe SARS-CoV-2 (as defined by hospital admission) were estimated by logistic regression models.
Results
The study included 236 patients with positive molecular test for SARS-CoV-2. Six patients died, 43 patients were admitted to hospital, 4 admitted to intensive care unit. Pancreatic insufficiency was associated with increased risk of severe COVID-19 (OR 4.04, 95% CI 1.52; 10.8). After adjusting for age and pancreatic insufficiency, forced expiratory volume in one second (FEVp) < 40% (OR 4.54, 95% CI 1.56; 13.2), oxygen therapy (OR 12.3, 95% CI 2.91–51.7), underweight (OR 2.92, 95% CI 1.12; 7.57), organ transplantation (OR 7.31, 95% CI 2.59; 20.7), diabetes (OR 2.67, 95% CI 1.23; 5.80) and liver disease (OR 3.67, 95% CI 1.77; 7.59) were associated with increased risk of severe COVID-19, while use of dornase alfa was associated with a reduced risk (OR 0.34, 95% CI 0.13–0.88). No significant changes were observed in FEVp from baseline to a median follow-up of 2 months (median difference: 0, interquartile range: − 4; 5,
P
 = 0.62).
Conclusion
Clinical features indicative of severe form of CF are associated with increased risk of COVID-19 hospitalization. SARS-CoV-2 infected patients do not experience a deterioration of respiratory function.