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