新冠疫情第一波对纽约囊性纤维化患者的临床影响。
The clinical impact of the Covid-19 pandemic first wave on patients with cystic fibrosis in New York.
作者信息
Simonson Joseph L, Esposito Christine, Frantzen Theresa, Henthorne Katherine, Espinal Aileen, Romano Serena, Ramdeo Ramona, Trentacoste Jessica, Tsang Donna, LaVecchia Geralyn, Abdullah Robert, Berdella Maria, Bonitz Lynn, Condos Rany, Constantinescu Andrei, DeCelie-Germana Joan K, DiMango Emily, Draine Myah, Gimeli Tara, Giusti Robert, Guzman Jessenia, Hammouda Soumia, Keating Claire, Kier Catherine, Lennox Alison T, Liriano Carmen, Messer Zachary, Plachta Amy, Sadeghi Hossein, Schwind Elinor, Stables-Carney Teresa, Walker Patricia, Wang Janice
机构信息
Division of Pulmonary, Critical Care and Sleep Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY 11042, United States.
Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11794, United States.
出版信息
J Cyst Fibros. 2022 May;21(3):e176-e183. doi: 10.1016/j.jcf.2022.02.012. Epub 2022 Feb 21.
BACKGROUND
People with cystic fibrosis (pwCF) may be at risk of complications from COVID-19 but the impact of COVID-19 on pwCF remains unknown.
METHODS
We conducted a multicenter retrospective cohort study to assess the impact of the COVID-19 pandemic first wave on pwCF in the New York metropolitan area (NY) from March 1, 2020 to August 31, 2020. Objectives were to determine (1) the prevalence of COVID-19 by PCR and IgG antibody testing, (2) the clinical characteristics of COVID-19, (3) delay in routine outpatient care, and (4) the effect on anxiety and depression in pwCF.
RESULTS
There were 26 COVID-19 cases diagnosed by PCR or antibody testing among the study cohort of 810 pwCF. The prevalence of COVID-19 by PCR (1.6%) and IgG antibody (12.2%) testing was low. 58% of cases were asymptomatic and 82% were managed at home. 8% were hospitalized and 1 person died. 89% of pwCF experienced delay in care. The prevalence of anxiety increased from 43% baseline to 58% during the pandemic (P<0.01). In post-hoc analysis, the proportion of patients with diabetes (38% versus 16%, P<0.01) and pancreatic insufficiency (96% versus 66%, P<0.01) were higher while CFTR modulator use was lower (46% versus 65%, P = 0.05) in pwCF who tested positive for COVID-19.
CONCLUSIONS
The prevalence of COVID-19 among pwCF in NY during the pandemic first wave was low and most cases were managed at home. CFTR modulators may be protective. PwCF experienced delay in routine care and increased anxiety.
背景
囊性纤维化患者（pwCF）可能面临新冠病毒病（COVID-19）并发症的风险，但COVID-19对pwCF的影响仍不清楚。
方法
我们进行了一项多中心回顾性队列研究，以评估2020年3月1日至2020年8月31日期间COVID-19大流行第一波对纽约市大都市区（NY）pwCF的影响。目标是确定：（1）通过聚合酶链反应（PCR）和IgG抗体检测得出的COVID-19患病率；（2）COVID-19的临床特征；（3）常规门诊护理的延迟情况；（4）对pwCF焦虑和抑郁的影响。
结果
在810例pwCF的研究队列中，通过PCR或抗体检测诊断出26例COVID-19病例。通过PCR检测（1.6%）和IgG抗体检测（12.2%）得出的COVID-19患病率较低。58%的病例无症状，82%在家中接受治疗。8%住院治疗，1人死亡。89%的pwCF经历了护理延迟。大流行期间，焦虑症患病率从基线时的43%升至58%（P<0.01）。在事后分析中，COVID-19检测呈阳性的pwCF中，糖尿病患者比例（38%对16%，P<0.01）和胰腺功能不全患者比例（96%对66%，P<0.01）较高，而使用CFTR调节剂的比例较低（46%对65%，P = 0.05）。
结论
大流行第一波期间，纽约市pwCF中COVID-19的患病率较低，大多数病例在家中接受治疗。CFTR调节剂可能具有保护作用。pwCF经历了常规护理延迟且焦虑增加。
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