Objective: There is still limited information on the clinical characteristics and outcomes of cystic fibrosis (CF) patients with COVID-19 in Brazil. The objective of this study was to describe the cumulative incidence of COVID-19 in CF patients, as well as their clinical characteristics and outcomes. Methods: This was a prospective cohort study involving unvaccinated adult CF patients and conducted during the first year of the SARS-CoV-2 pandemic in the city of Porto Alegre, in southern Brazil. The clinical course of the disease was rated on the WHO Ordinal Scale for Clinical Improvement. The primary outcome was the number of incident cases of COVID-19. Results: Between April 30, 2020 and April 29, 2021, 98 CF patients were included in the study. Seventeen patients were diagnosed with COVID-19. For the CF patients, the annual cumulative incidence of COVID-19 was 17.3%, similar to that for the general population, adjusted for age (18.5%). The most common symptoms at diagnosis of COVID-19 were cough (in 59%), dyspnea (in 53%), fatigue (in 53%), and fever (in 47%). Only 6 (35%) of the patients required hospitalization, and 3 (17.6%) required oxygen support. Only 1 patient required mechanical ventilation, having subsequently died. Conclusions: During the first year of the SARS-CoV-2 pandemic in southern Brazil, the cumulative incidence rate of COVID-19 was similar between CF patients and the general population. More than 50% of the CF patients with SARS-CoV-2 infection had a mild clinical presentation, without the need for hospital admission, and almost the entire sample recovered completely from the infection, the exception being 1 patient who had advanced lung disease and who died.
Cystic fibrosis (CF) patients experience a continuous acute phase of inflammatory and catabolic state. Longitudinal study to assess the impact of severe infectious pulmonary exacerbation on fat-free mass (FFM) and on the fat-free mass index (FFMI) in adults with CF who required hospital admission. Nutritional assessment using anthropometry and bioimpedance, Visual Appetite Scale (VAS), Kanga Score, functional assessment by spirometry and a 6-minute walk test. Inflammatory biochemical markers cortisol and C-Reactive Protein were also used. Results: The multivariate linear regression analysis identified only sex as an independent variable significantly associated with improvement in the FFMI (B= -1.81, 95% CI= -3.10; -0.51, p=0.008). As for the increase in FFM, two significantly associated independent variables were identified: sex (B= -10.38, confidence interval – 95% CI= -14.70; -6.06, p<0.001); and forced vital capacity (FVC) % of predicted (B=0.13, 95% CI=0.04; 0.23, p=0.006). There was a significant improvement in FFM and FFMI between the start of hospitalization and the 14th day. Gender and FVC % of predicted were responsible for predicting FFM improvement. For the FFMI, the predictive variable of this improvement was gender only, with males having the greatest increase in FFM and FFMI.
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