Highlights COVID-19 had an impact on the emotional well-being of patients and parents of children with CF. Many patients report more sadness, discouragement, feelings of helplessness, greater criticism of others, perceptions of deterioration of the situation and difficulty with adhering to their routine. Symptoms of posttraumatic stress were elevated, which is worrying, especially if this psychological impact is sustained. Psychological follow-up is necessary to prevent the development of post-traumatic stress disorders. Adult patients with mild CF disease report more worries and stress compared to those with more severe disease. Contingency measures, family responsibilities, fear or deterioration and/or fear of losing control, may explain this unanticipated result. Further research is warranted. Many patients and parents of children with CF report positive changes in home treatment, including ‘eating extra and healthier’, ‘improvement in the quality of nebulizing’ and ‘better physiotherapy’. The challenge for both patients, parents and CF teams, is how to maintain these positive changes over time and promote permanence in resilience. It is important to contextualize the information patients and parents receive about COVID-19 from the media and to support them in balancing perceived risk and true risk. There is a crucial role for multidisciplinary teams, which can pro-actively connect with, inform and support the patients and parents.

In all, this study is the first randomized controlled trial to provide information on the safety of intranasal oxytocin administration in middle childhood. The current study suggests that single administration of intranasal oxytocin is likely safe in elementary school-aged children.