2019冠状病毒病对囊性纤维化患者肺部疾病的影响：一项关于呼吸结局的6个月随访研究
Impact of COVID-19 on Lung Disease in People with Cystic Fibrosis: A 6-Month Follow-Up Study on Respiratory Outcomes.
作者信息
Medino Paola, Alicandro Gianfranco, Rosazza Chiara, Ciciriello Fabiana, Gramegna Andrea, Biffi Arianna, Daccò Valeria, Lucidi Vincenzina, Cipolli Marco, Boraso Mariaserena, Nazzari Erica, Colombo Carla
机构信息
Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 9, 20122 Milano, MI, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122 Milano, MI, Italy.
出版信息
Biomedicines. 2022 Nov 1;10(11):2771. doi: 10.3390/biomedicines10112771.
BACKGROUND
The impact of COVID-19 on respiratory outcomes in people with cystic fibrosis (pwCF) has not been clearly characterized. We evaluated changes in respiratory function indicators derived from spirometry and pulmonary exacerbation rates 6 months after SARS-CoV-2 infection.
METHODS
This multicentre prospective study was based on pwCF enrolled between October, 2020 and June, 2021 in the DECO COVID-19 project. PwCF complaining of COVID-like symptoms were tested with real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 on nasopharyngeal swab. Mean changes in respiratory function indicators and time to first episode of pulmonary exacerbation were compared in RT-PCR-positive and RT-PCR-negative patients. Regression models were used to adjust for baseline percent predicted forced expiratory volume in one second (ppFEV1) values, number of comorbidities, and initiation of CFTR modulator therapy during the follow-up.
RESULTS
We enrolled 26 pwCF with RT-PCR-confirmed infection and 42 with a RT-PCR-negative test. After 6 months of follow-up, mean ppFEV1 changes were not significantly different between groups (+0.3% in positive vs. +0.2% in negative patients, = 0.19). The 6-month cumulative probabilities of a first episode of pulmonary exacerbation were: 0.425 among RT-PCR-negative patients and 0.465 among those with a positive test (adjusted hazard ratio: 0.88, 95% CI: 0.44-1.75).
CONCLUSIONS
COVID-19 did not appear to negatively influence respiratory outcomes of pwCF at 6 months from infection.
背景
新冠病毒病（COVID-19）对囊性纤维化患者（pwCF）呼吸结局的影响尚未明确。我们评估了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染6个月后，肺功能测定得出的呼吸功能指标变化以及肺部加重率。
方法
这项多中心前瞻性研究基于2020年10月至2021年6月纳入DECO COVID-19项目的pwCF。对出现类似新冠症状的pwCF进行鼻咽拭子实时聚合酶链反应（RT-PCR）检测SARS-CoV-2。比较RT-PCR阳性和RT-PCR阴性患者呼吸功能指标的平均变化以及首次肺部加重发作的时间。采用回归模型对随访期间的一秒用力呼气容积预测值百分比（ppFEV1）基线值、合并症数量以及CFTR调节剂治疗的起始情况进行校正。
结果
我们纳入了26例RT-PCR确诊感染的pwCF和42例RT-PCR检测阴性的患者。随访6个月后，两组之间的ppFEV1平均变化无显著差异（阳性患者为+0.3%，阴性患者为+0.2%，P = 0.19）。首次肺部加重发作的6个月累积概率在RT-PCR阴性患者中为0.425，在检测阳性患者中为0.465（校正风险比：0.88，95%置信区间：0.44 - 1.75）。
结论
感染6个月时，COVID-19似乎未对pwCF的呼吸结局产生负面影响。
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