Impact of lockdown during the COVID-19 pandemic on health status in patients with cystic fibrosis- a mono-center observational study

Abstract

Patients with cystic fibrosis (CF) suffer from impaired mucociliary clearance making them more susceptible to a spectrum of inhaled pathogens including bacteria, fungi and viruses [1, 2]. Therefore, patients with CF were considered at high risk for serious illness following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leading to “shielding or cocooning policies” [3]. Usually, patients with CF are cared for in specialised CF clinics with regular check-up visits. It was shown that regular care by multidisciplinary CF teams with highly trained staff lead to improvement in clinical outcomes in patient with CF [4]. At our centre, patients are usually seen at least quarterly. Between March and May 2020, at the peak of the first wave of SARS-CoV-2 infection in Germany, national authorities imposed an 8-week lockdown period on the entire population. During this period, hospitals and health care facilities reduced elective health care services including outpatient clinics to a minimum to focus their resources on the care of patients with coronavirus disease 2019 (COVID-19). Accordingly, all scheduled visits to our CF outpatient clinic were postponed and patients were advised to stay in home isolation. Additionally, due to lockdown measures, the patients’ possibilities for performing supportive therapies such as chest physiotherapy or physical exercise were limited. Hospital admission in case of severe clinical deterioration, e.g. pulmonary exacerbation, was available. Replacement of scheduled visits by e.g. video consultation or care by non-physician members of the multidisciplinary team was not yet implemented at this first lock-down period.