Department of Respirology, St. Michael's Hospital, Toronto, Ontario, Canada.
UK Trust, London, United Kingdom.
J Cyst Fibros. 2024 Sep;23(5):815-822. doi: 10.1016/j.jcf.2024.07.019. Epub 2024 Aug 26.
Factors associated with severe COVID-19 infection have been identified; however, the impact of infection on longer-term outcomes is unclear. The objective of this study was to examine the impact of COVID-19 infection on the trajectory of lung function and nutritional status in people with cystic fibrosis (pwCF).
This is a retrospective global cohort study of pwCF who had confirmed COVID-19 infection diagnosed between January 1, 2020 and December 31, 2021. Forced expiratory volume in one second percent predicted (ppFEV) and body mass index (BMI) twelve months prior to and following a diagnosis of COVID-19 were recorded. Change in mean ppFEV and BMI were compared using a t-test. A linear mixed-effects model was used to estimate change over time and to compare the rate of change before and after infection.
A total of 6,500 cases of COVID-19 in pwCF from 33 countries were included for analysis. The mean difference in ppFEV pre- and post-infection was 1.4 %, (95 % CI 1.1, 1.7). In those not on modulators, the difference in rate of change pre- and post-infection was 1.34 %, (95 % CI -0.88, 3.56) per year (p = 0.24) and -0.74 % (-1.89, 0.41) per year (p = 0.21) for those on elexacaftor/tezacaftor/ivacaftor. No clinically significant change was noted in BMI or BMI percentile before and after COVID-19 infection.
No clinically meaningful impact on lung function and BMI trajectory in the year following infection with COVID-19 was identified. This work highlights the ability of the global CF community to unify and address critical issues facing pwCF.
已确定与严重 COVID-19 感染相关的因素;然而,感染对长期结果的影响尚不清楚。本研究的目的是研究 COVID-19 感染对囊性纤维化(pwCF)患者肺功能和营养状况轨迹的影响。
这是一项回顾性全球队列研究,纳入了 2020 年 1 月 1 日至 2021 年 12 月 31 日期间确诊 COVID-19 感染的 pwCF。记录确诊 COVID-19 前 12 个月和确诊后 12 个月的一秒用力呼气容积占预计值的百分比(ppFEV)和体重指数(BMI)。使用 t 检验比较平均 ppFEV 和 BMI 的变化。使用线性混合效应模型估计随时间的变化,并比较感染前后的变化率。
共纳入 33 个国家的 6500 例 pwCF 感染 COVID-19 的病例进行分析。感染前后 ppFEV 的平均差异为 1.4%(95%CI,1.1%,1.7%)。在未服用调节剂的患者中,感染前后变化率的差异为 1.34%(95%CI,-0.88%,3.56%)/年(p=0.24)和-0.74%(-1.89%,0.41%)/年(p=0.21),对于服用 elexacaftor/tezacaftor/ivacaftor 的患者。感染 COVID-19 前后,BMI 或 BMI 百分位数无临床意义的变化。
在感染 COVID-19 后的一年中,未发现肺功能和 BMI 轨迹有临床意义的影响。这项工作突出了全球 CF 社区团结起来解决 pwCF 面临的关键问题的能力。