Impact of SARS-CoV-2 infection in patients with cystic fibrosis in Spain: Incidence and results of the national CF-COVID19-Spain survey

Abstract

Background Given the high incidence of confirmed infection by SARS-CoV-2 and mortality by COVID-19 in the Spanish population, its impact was analysed among persons with Cystic Fibrosis (CF) as a group at risk of a worse evolution. The possible causes of the incidence observed in them are explained and how CF Units have faced this health challenge is detailed. Methods Retrospective descriptive observational study, for which a Spanish CF Patients with Confirmed COVID-19 Registry is created, requesting information on number of people affected between 8 March–16 May 2020 and their clinical-demographic characteristics from the CF Units participating in the European Cystic Fibrosis Society Patient Registry (ECFSPR). The accumulated incidence is calculated, compared with that of the general population. Additionally, a survey (CF-COVID19-Spain) is carried out on prevention of SARS-CoV-2 infection, workings of CF Units and possible reasons for the incidence observed. Results COVID-19 was diagnosed in eight CF patients, one of whom had received a lung transplant. The accumulated incidence was 32/10000 in CF patients and 49/10000 in the general population. General death rate was 5.85/10000 while no CF patients included in the ECFSPR died. The characteristics of those affected and the results of the survey are described. Conclusions Despite being considered a disease at high risk of severe COVID-19, the low incidence and mortality in CF patients in Spain contrasts with the figures for the general population. The possible factors that would explain such findings are discussed, with the help of the results of the CF-COVID19-Spain survey.

Antihistamines and azithromycin as a treatment for COVID-19 on primary health care – A retrospective observational study in elderly patients

“…Although this study is descriptive, our results bear some similarities with other studies [ 26 , 36 , 37 ]. Mast cells seem to play an important role in the inflammatory responses by releasing granules of histamine, in addition to synthesizing and secrete inflammatory lipid mediators and pro-inflammatory cytokines TNF-α and IL-6 [ 38 ].…”

“…Although our experience and research are about azithromycin, other macrolides may have similar properties [ [23] , [24] , [25] ]. In patients with cystic fibrosis, many of whom have chronic treatment with azithromycin and other antibiotics, low morbidity and mortality are being registered, in contrast to what would be expected as a high risk pathology [ 26 ]. The Patient Registry of the European Cystic Fibrosis Society has so far collected data from 180 documented cases from 20 countries, of which 70 were hospitalized, 12 in the ICU and have only recorded 5 deaths [ 27 ].…”

Immune transcriptomes of highly exposed SARS-CoV-2 asymptomatic seropositive versus seronegative individuals from the Ischgl community

“…Patients with CF manifest cytokine dysfunction and hyperinflammation that overlaps with the pathophysiology of COVID-19 19 . While there are limited data on the immune response of CF patients to COVID-19 infection, preliminary information suggests that the course of disease may be milder than expected 20 , 21 . The immune transcriptome of the asymptomatic seropositive CF patient provided evidence of highly activated cytokine signaling pathways.…”

Immune transcriptomes of highly exposed SARS-CoV-2 asymptomatic seropositive versus seronegative individuals from the Ischgl community

“…Patients with CF manifest cytokine dysfunction and hyperin ammation that overlaps with the pathophysiology of COVID-19 19 . While there are limited data on the immune response of CF patients to COVID-19 infection, preliminary information suggests that the course of disease may be milder than expected 20,21 . The immune transcriptome of the asymptomatic seropositive CF patient provided evidence of highly activated cytokine signaling pathways.…”