5
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      The global impact of SARS-CoV-2 in 181 people with cystic fibrosis

      brief-report
      a , * , a , a , b , c , d , e , f , g , h , i , i , j , k , l , m , n , o , p , i , q , r , s , t , u , i , b , v , g , w , x , y , z , 1
      Journal of Cystic Fibrosis
      Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society.

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Highlights

          • We report 181 people with CF from 19 countries diagnosed with SARS-CoV-2

          • Spectrum of outcomes observed was similar to that seen in the general population

          • 11 people were admitted to intensive care and 7 died

          • Three of the people who died had received an organ transplant

          • Lower lung function and having been transplanted may be linked to hospitalisation

          Abstract

          With the growing SARS-CoV-2 pandemic, we need to better understand its impact in specific patient groups like those with Cystic Fibrosis (CF). We report on 181 people with CF (32 post-transplant) from 19 countries diagnosed with SARS-CoV-2 prior to 13 June 2020. Infection with SARS-CoV-2 appears to exhibit a similar spectrum of outcomes to that seen in the general population, with 11 people admitted to intensive care (7 post-transplant), and 7 deaths (3 post-transplant). A more severe clinical course may be associated with older age, CF-related diabetes, lower lung function in the year prior to infection, and having received an organ transplant. Whilst outcomes in this large cohort are better than initially feared overall, possibly due to a protective effect of the relatively younger age of the CF population compared to other chronic conditions, SARS-CoV-2 is not a benign disease for all people in this patient group.

          Related collections

          Most cited references7

          • Record: found
          • Abstract: found
          • Article: not found

          Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study

          Summary Background Diabetes has been associated with increased COVID-19-related mortality, but the association between modifiable risk factors, including hyperglycaemia and obesity, and COVID-19-related mortality among people with diabetes is unclear. We assessed associations between risk factors and COVID-19-related mortality in people with type 1 and type 2 diabetes. Methods We did a population-based cohort study of people with diagnosed diabetes who were registered with a general practice in England. National population data on people with type 1 and type 2 diabetes collated by the National Diabetes Audit were linked to mortality records collated by the Office for National Statistics from Jan 2, 2017, to May 11, 2020. We identified the weekly number of deaths in people with type 1 and type 2 diabetes during the first 19 weeks of 2020 and calculated the percentage change from the mean number of deaths for the corresponding weeks in 2017, 2018, and 2019. The associations between risk factors (including sex, age, ethnicity, socioeconomic deprivation, HbA1c, renal impairment [from estimated glomerular filtration rate (eGFR)], BMI, tobacco smoking status, and cardiovascular comorbidities) and COVID-19-related mortality (defined as International Classification of Diseases, version 10, code U07.1 or U07.2 as a primary or secondary cause of death) between Feb 16 and May 11, 2020, were investigated by use of Cox proportional hazards models. Findings Weekly death registrations in the first 19 weeks of 2020 exceeded the corresponding 3-year weekly averages for 2017–19 by 672 (50·9%) in people with type 1 diabetes and 16 071 (64·3%) in people with type 2 diabetes. Between Feb 16 and May 11, 2020, among 264 390 people with type 1 diabetes and 2 874 020 people with type 2 diabetes, 1604 people with type 1 diabetes and 36 291 people with type 2 diabetes died from all causes. Of these total deaths, 464 in people with type 1 diabetes and 10 525 in people with type 2 diabetes were defined as COVID-19 related, of which 289 (62·3%) and 5833 (55·4%), respectively, occurred in people with a history of cardiovascular disease or with renal impairment (eGFR <60 mL/min per 1·73 m2). Male sex, older age, renal impairment, non-white ethnicity, socioeconomic deprivation, and previous stroke and heart failure were associated with increased COVID-19-related mortality in both type 1 and type 2 diabetes. Compared with people with an HbA1c of 48–53 mmol/mol (6·5–7·0%), people with an HbA1c of 86 mmol/mol (10·0%) or higher had increased COVID-19-related mortality (hazard ratio [HR] 2·23 [95% CI 1·50–3·30, p<0·0001] in type 1 diabetes and 1·61 [1·47–1·77, p<0·0001] in type 2 diabetes). In addition, in people with type 2 diabetes, COVID-19-related mortality was significantly higher in those with an HbA1c of 59 mmol/mol (7·6%) or higher than in those with an HbA1c of 48–53 mmol/mol (HR 1·22 [95% CI 1·15–1·30, p<0·0001] for 59–74 mmol/mol [7·6–8·9%] and 1·36 [1·24–1·50, p<0·0001] for 75–85 mmol/mol [9·0–9·9%]). The association between BMI and COVID-19-related mortality was U-shaped: in type 1 diabetes, compared with a BMI of 25·0–29·9 kg/m2, a BMI of less than 20·0 kg/m2 had an HR of 2·45 (95% CI 1·60–3·75, p<0·0001) and a BMI of 40·0 kg/m2 or higher had an HR of 2·33 (1·53–3·56, p<0·0001); the corresponding HRs for type 2 diabetes were 2·33 (2·11–2·56, p<0·0001) and 1·60 (1·47–1·75, p<0·0001). Interpretation Deaths in people with type 1 and type 2 diabetes rose sharply during the initial COVID-19 pandemic in England. Increased COVID-19-related mortality was associated not only with cardiovascular and renal complications of diabetes but, independently, also with glycaemic control and BMI. Funding None.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            The effect of age on mortality in patients with Covid-19: a metanalysis with 611,583 subjects

            Objectives Initial data on Covid-19 infection has pointed out a special vulnerability of elderly people. Design we performed a meta-analysis with available national reports at May 7th 2020 from China, Italy, Spain, United Kingdom and New York State. Analyses were performed by a random effects model and sensitivity analyses were performed for the identification of potential sources of heterogeneity. Setting and Participants: covid-19 positive patients reported in literature and national reports. Measures all-cause mortality by age. Results A total of 611,1583 subjects were analyzed and 141,745 (23.2%) had age ≥80. The percentage of octogenarians was different in the 5 registries being the lowest in China (3.2%) and the highest and the highest in UK and New York State. The overall mortality rate was 12.10% and it varied widely between countries being the lowest in China (3.1%) and the highest in UK (20.8%) and New York State (20.99%). Mortality was 50 and, especially, >60. Elderly patients should be priorized in the implementation of preventive measures.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Biological sex impacts COVID-19 outcomes

              The current novel coronavirus disease 2019 (COVID-19) pandemic is revealing profound differences between men and women in disease outcomes worldwide. In the United States, there has been inconsistent reporting and analyses of male–female differences in COVID-19 cases, hospitalizations, and deaths. We seek to raise awareness about the male-biased severe outcomes from COVID-19, highlighting the mechanistic differences including in the expression and activity of angiotensin-converting enzyme 2 (ACE2) as well as in antiviral immunity. We also highlight how sex differences in comorbidities, which can be associated with both age and race, impact male-biased outcomes from COVID-19.
                Bookmark

                Author and article information

                Journal
                J Cyst Fibros
                J Cyst Fibros
                Journal of Cystic Fibrosis
                Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society.
                1569-1993
                1873-5010
                4 November 2020
                4 November 2020
                Affiliations
                [a ]Cystic Fibrosis Trust, UK
                [b ]Monash University, Melbourne, Australia
                [c ]Université de Paris, Inserm U1016, Institut Cochin and Cochin Hospital, Assistance Publique Hôpitaux de Paris (APHP), France
                [d ]Starship Children's Hospital and University of Auckland, Auckland, New Zealand
                [e ]Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
                [f ]Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Paris, France
                [g ]Cystic Fibrosis Canada, Canada
                [h ]Sciensano, Belgium
                [i ]Cystic Fibrosis Foundation, USA
                [j ]University of Washington, Seattle, USA
                [k ]Dutch CF Foundation NCFS, Baarn, Netherlands
                [l ]University of Alabama at Birmingham, Alabama, USA
                [m ]Stockholm CF Center, Sweden
                [n ]University Children's Hospital Zurich, Switzerland
                [o ]Department of Pediatrics, Justus-Liebig-University Giessen, Giessen, Germany
                [p ]Research Centre for Medical Genetics, Russia
                [q ]St Vincent's University Hospital, Dublin, Ireland
                [r ]Westmead Hospital, Sydney, Australia
                [s ]Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
                [t ]Hospital Universitario Cruces, Bizkaia, Spain
                [u ]Cystic Fibrosis Support Center, Department of Paediatric, University of Brescia, Italy
                [v ]National Center Rare Diseases Undiagnosed Rare Diseases Interdepartmental Unit Istituto Superiore di Sanità, Rome, Italy
                [w ]Toronto Adult Cystic Fibrosis Centre, St. Michael's Hospital, Toronto, Canada
                [x ]Instituto da Criança HCFMUSP, São Paulo, Brazil
                [y ]Instituto Nacional del Tórax, Chile
                [z ]University of Cape Town and Red Cross War Memorial Children's Hospital, South Africa
                [1 ]Royal Brompton Hospital and Imperial College London
                Author notes
                [* ]Corresponding author: Elliot McClenaghan, Cystic Fibrosis Trust, UK CF Registry, 1 Aldgate, London EC3N 1RE, United Kingdom, Tel: 07713232774
                Article
                S1569-1993(20)30877-8
                10.1016/j.jcf.2020.10.003
                7641525
                33183965
                eafda754-d01a-47eb-ba45-cd32561ef016
                © 2020 Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 14 September 2020
                : 21 October 2020
                : 23 October 2020
                Categories
                Short Communication

                Genetics
                Genetics

                Comments

                Comment on this article