Mondejar-Lopez Pedro, Moreno-Galarraga Laura, de Manuel-Gomez Cristina, Blitz-Castro Enrique, Bravo-Lopez Maynor, Gartner Silvia, Perez-Ruiz Estela, Caro-Aguilera Pilar, Sanz-Santiago Veronica, Lopez-Neyra Alejandro, Luna-Paredes Carmen, Garcia-Gonzalez Miguel, Costa-Colomer Jordi, Cols-Roig Maria, Delgado-Pecellin Isabel, Castillo-Corullon Silvia, Ruiz de Valbuena-Maiz Marta, Garcia-Marcos Patricia W, Aguilar-Fernandez Antonio J, Martin-De Vicente Carlos, Barajas-Sanchez Mª Verisima, Mesa-Medina Orlando, Bover-Bauza Catalina, Figuerola-Mulet Joan, Garcia-Aviles Belen, Rodriguez-Saez Mª Jesus, Garcia-Magan Carlos, Juarez-Marruecos Patricia, Gutierrez-Martinez Jose Ramon, Cortell-Aznar Isidoro, Gomez-Pastrana David, Velasco-Gonzalez M Valle, Barrio M Isabel, Sanchez-Solis Manuel, Asensio de la Cruz Oscar, Pastor-Vivero Maria Dolores
Pediatric Pulmonology and Cystic Fibrosis Unit, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain.
Department of Surgery, Paediatrics, Obstetrics and Genecology, Biomedical Research Institute of Murcia (IMIB), Universidad de Murcia, Murcia, Spain.
Pediatr Pulmonol. 2023 Nov;58(11):3195-3205. doi: 10.1002/ppul.26644. Epub 2023 Aug 17.
The association between viral infections and pulmonary exacerbations in children with cystic fibrosis (cwCF) is well established. However, the question of whether cwCF are at a higher risk of COVID-19 or its adverse consequences remains controversial.
We conducted an observational, multicenter, cross-sectional study of cwCF infected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) between March 2020 and June 2022, (first to sixth COVID-19 pandemic waves) in Spain. The study aimed to describe patients' basal characteristics, SARS-CoV-2 clinical manifestations and outcomes, and whether there were differences across the pandemic waves.
During study time, 351 SARS-CoV2 infections were reported among 341 cwCF. Median age was 8.5 years (range 0-17) and 51% were female. Cases were unevenly distributed across the pandemic, with most cases (82%) clustered between November 2021 and June 2022 (sixth wave, also known as Omicron Wave due to the higher prevalence of this strain in that period in Spain). Most cwCF were asymptomatic (24.8%) or presented with mild Covid-19 symptoms (72.9%). Among symptomatic, most prevalent symptoms were fever (62%) and increased cough (53%). Infection occurring along the sixth wave was the only independent risk factor for being symptomatic. Just eight cwCF needed hospital admission. No multisystem inflammatory syndrome, persisting symptoms, long-term sequelae, or deaths were reported.
Spanish current data indicate that cwCF do not experience higher risks of SARS-CoV-2 infection nor worse health outcomes or sequelae. Changes in patients' basal characteristics, clinical courses, and outcomes were detected across waves. While the pandemic continues, a worldwide monitoring of COVID-19 in pediatric CF patients is needed.
囊性纤维化患儿（cwCF）的病毒感染与肺部加重之间的关联已得到充分证实。然而，cwCF感染2019冠状病毒病（COVID-19）或出现其不良后果的风险是否更高，这一问题仍存在争议。
我们于2020年3月至2022年6月（西班牙COVID-19大流行的第一波至第六波）对感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的cwCF进行了一项观察性、多中心横断面研究。该研究旨在描述患者的基础特征、SARS-CoV-2的临床表现和结局，以及各波大流行期间是否存在差异。
在研究期间，341例cwCF中报告了351例SARS-CoV-2感染。中位年龄为8.5岁（范围0 - 17岁），51%为女性。病例在大流行期间分布不均，大多数病例（82%）集中在2021年11月至2022年6月之间（第六波，由于该毒株在西班牙该时期的高流行率，也称为奥密克戎波）。大多数cwCF无症状（24.8%）或表现为轻度COVID-19症状（72.9%）。有症状的患者中，最常见的症状是发热（62%）和咳嗽加重（53%）。第六波期间发生的感染是出现症状的唯一独立危险因素。仅8例cwCF需要住院治疗。未报告多系统炎症综合征、持续症状、长期后遗症或死亡病例。
西班牙目前的数据表明，cwCF感染SARS-CoV-2的风险并不更高，健康结局或后遗症也不更差。各波期间检测到患者的基础特征、临床病程和结局有所变化。在大流行仍在持续的情况下，需要对儿科囊性纤维化患者的COVID-19进行全球监测。
