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Clin Infect Dis . Cumulative Incidence and Risk Factors for Severe COVID-19 in French People with Cystic Fibrosis

tetano

Editor, Senior Moderator
Clin Infect Dis


. 2022 Apr 27;ciac333.
doi: 10.1093/cid/ciac333. Online ahead of print.
Cumulative Incidence and Risk Factors for Severe COVID-19 in French People with Cystic Fibrosis


Harriet Corvol[SUP] 1 2 [/SUP], Sandra de Miranda[SUP] 3 [/SUP], Clémence Dehillotte[SUP] 4 [/SUP], Lydie Lemonnier[SUP] 4 [/SUP], Raphael Chiron[SUP] 5 [/SUP], Isabelle Danner-Boucher[SUP] 6 [/SUP], Rebecca Hamidfar[SUP] 7 [/SUP], Véronique Houdouin[SUP] 8 [/SUP], Julie Macey[SUP] 9 [/SUP], Christophe Marguet[SUP] 10 [/SUP], Marlène Murris-Espin[SUP] 11 [/SUP], Quitterie Reynaud[SUP] 12 13 [/SUP], Philippe Reix[SUP] 14 [/SUP], Martine Reynaud Gaubert[SUP] 15 [/SUP], Astrid Kemgang[SUP] 2 [/SUP], Pierre-Régis Burgel[SUP] 16 17 13 [/SUP], French Cystic Fibrosis Reference Network study group



Affiliations

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are closely monitored in people with cystic fibrosis (pwCF), with a special emphasis on severe cases. Previous studies used hospitalization rates as proxy for severity.
Methods: We evaluated data from coronavirus disease 2019 (COVID-19) cases diagnosed in French pwCF followed in one of the 47 French CF center over the first year of the pandemic.
Objective: criteria were applied for defining severity (e.g., respiratory failure and/or death). Data were compared to those from all French pwCF using the French CF Registry.
Results: As of April 30, 2021, 223 pwCF were diagnosed with COVID-19, with higher risks in adults (≥18 years, odds ratio [OR] = 2.52, 95% confidence interval [CI] = 1.82-3.48) and post-transplant individuals (OR = 2.68, 95% CI = 1.98-3.63). Sixty (26.9%) patients were hospitalized, with an increased risk in post-transplant individuals (OR = 4.74, 95% CI = 2.49-9.02). In 34 (15%) cases, COVID-19 was considered severe; 28/60 (46.7%) hospitalizations occurred in patients without objective criteria of severity. Severe cases occurred mostly in adults (85.3%) and post-transplant pwCF (61.8%, OR = 6.02, 95% CI = 2.77-13.06). In non-transplanted pwCF, risk factors for severity included low lung function (median ppFEV1 54.6% vs. 75.1%, OR = 1.04, 95% CI = 1.01-1.08) and CF-associated diabetes (OR = 3.26, 95% CI = 1.02-10.4). While most cases recovered without sequelae (n = 204, 91.5%), 16 (13%) were followed for possible sequelae, and three post-transplant females died.
Conclusions: Severe COVID-19 cases occurred infrequently during the first year of the pandemic in French pwCF. Non-transplanted adults with severe respiratory disease or diabetes and post-transplant individuals were at risk for severe COVID-19. Thus, specific preventive measures should be proposed.

Keywords: COVID-19; SARS-CoV-2; cystic fibrosis; risk factors; severity.
 
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