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J Pediatr Infect Dis 2023; 18(05): 232-239
DOI: 10.1055/s-0043-1769902
Original Article

An Evaluation of the Risk Factors and Respiratory Function Test Change of Children with Cystic Fibrosis Who Contracted COVID-19 Infection

Mehmet Mustafa Özaslan 
1   Pediatric Pulmonology, Ege University Faculty of Medicine, İzmir, Türkiye
,
Handan Duman Şenol
2   Pediatric Allery and İmmünology, Ege University Faculty of Medicine, İzmir, Türkiye
,
Meral Barlık
1   Pediatric Pulmonology, Ege University Faculty of Medicine, İzmir, Türkiye
,
Fevziye Çoksuer
1   Pediatric Pulmonology, Ege University Faculty of Medicine, İzmir, Türkiye
,
Bahar Girgin Dindar
1   Pediatric Pulmonology, Ege University Faculty of Medicine, İzmir, Türkiye
,
Esen Demir
1   Pediatric Pulmonology, Ege University Faculty of Medicine, İzmir, Türkiye
,
Figen Gülen
1   Pediatric Pulmonology, Ege University Faculty of Medicine, İzmir, Türkiye
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Abstract

Objective Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020, with millions of infected cases worldwide. Although the course is usually mild in the pediatric age group, there are unknown factors in patients with chronic lung diseases. The aim of this study was to determine the demographic characteristics and the clinical course of patients with cystic fibrosis who contracted COVID-19 infection.

Methods A total of 128 patients with cystic fibrosis who were under follow-up in our clinic were separated into two groups: those who had been infected with COVID-19 and those who had not. The COVID-19-positive patients were then grouped as those who were hospitalized and those treated as outpatients. In the COVID-19 group, the spirometry values of the patients before the infection were compared with those measured at 3 and 6 months after the infection.

Results The COVID-19 group comprised 34 (25.6%) cystic fibrosis patients with a mean age of 108.2 ± 60.8 months who contracted COVID-19 between April 2020 and October 2022. The rates of chronic bacterial colonization and allergic bronchopulmonary aspergillosis were significantly higher in the COVID-19 group (p = 0.001 and 0.005). Eight of the 34 patients were hospitalized, and 26 were isolated at home. Five patients required oxygen, and the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) values were lower.

Conclusion A severe course of COVID-19 was not seen in any of the cystic fibrosis patients. A greater number of patients with chronic respiratory tract bacterial colonization and allergic bronchopulmonary aspergillosis were hospitalized.

Keywords

cystic fibrosis - COVID-19 - children

Note

The study was approved by Ege University Clinical Research Ethics Committee and financially supported by Ege University Office of Scientific Research Projects (Project No: 22-7T/32).




Publication History

Received: 23 December 2022

Accepted: 02 May 2023

Article published online:
12 June 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395 (10223): 497-506
    CrossrefPubMedGoogle Scholar
  • 2 Wu F, Zhao S, Yu B. et al. A new coronavirus associated with human respiratory disease in China. Nature 2020; 579 (7798): 265-269
    CrossrefPubMedGoogle Scholar
  • 3 Nguyen HL, Lan PD, Thai NQ, Nissley DA, O'Brien EP, Li MS. Does SARS-CoV-2 bind to human ACE2 more strongly than does SARS-CoV?. J Phys Chem B 2020; 124 (34) 7336-7347
    CrossrefPubMedGoogle Scholar
  • 4 Bunyavanich S, Do A, Vicencio A. Nasal gene expression of angiotensin-converting enzyme 2 in children and adults. JAMA 2020; 323 (23) 2427-2429
    CrossrefPubMedGoogle Scholar
  • 5 Howard-Jones AR, Burgner DP, Crawford NW. et al. COVID-19 in children. II: Pathogenesis, disease spectrum and management. J Paediatr Child Health 2022; 58 (01) 46-53
    CrossrefPubMedGoogle Scholar
  • 6 Viner RM, Ward JL, Hudson LD. et al. Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents. Arch Dis Child 2020; 106: 802-807
    CrossrefPubMedGoogle Scholar
  • 7 Götzinger F, Santiago-García B, Noguera-Julián A. et al; ptbnet COVID-19 Study Group. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. Lancet Child Adolesc Health 2020; 4 (09) 653-661
    CrossrefPubMedGoogle Scholar
  • 8 Halpin DMG, Faner R, Sibila O, Badia JR, Agusti A. Do chronic respiratory diseases or their treatment affect the risk of SARS-CoV-2 infection?. Lancet Respir Med 2020; 8 (05) 436-438
    CrossrefPubMedGoogle Scholar
  • 9 Bain R, Cosgriff R, Zampoli M. et al. Clinical characteristics of SARS-CoV-2 infection in children with cystic fibrosis: an international observational study. J Cyst Fibros 2021; 20 (01) 25-30
    CrossrefPubMedGoogle Scholar
  • 10 Quanjer PH, Stanojevic S, Cole TJ. et al; ERS Global Lung Function Initiative. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J 2012; 40 (06) 1324-1343
    CrossrefPubMedGoogle Scholar
  • 11 de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007; 85 (09) 660-667
    CrossrefPubMedGoogle Scholar
  • 12 Bhuiyan MU, Stiboy E, Hassan MZ. et al. Epidemiology of COVID-19 infection in young children under five years: a systematic review and meta-analysis. Vaccine 2021; 39 (04) 667-677
    CrossrefPubMedGoogle Scholar
  • 13 Lifen Y, Zhen Yuan D, Mengqi D. et al. Suggestions for medical staff from department of pediatrics during the treatment of 2019-nCoV infection/pneumonia. J Nat Med 2020; 51 (02) 77-84
    PubMedGoogle Scholar
  • 14 Centers for Disease Control and Prevention. Demographic trends of COVID-19 cases and deaths in the US reported to CDC: cases by race/ethnicity; deaths by race/ethnicity; cases by age group; deaths by age group; cases by sex; deaths by sex. Published on December 22, 2020. Accessed April 7, 2022 at: https://stacks.cdc.gov/view/cdc/99332
    PubMedGoogle Scholar
  • 15 Kabeerdoss J, Pilania RK, Karkhele R, Kumar TS, Danda D, Singh S. Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management. Rheumatol Int 2021; 41 (01) 19-32
    CrossrefPubMedGoogle Scholar
  • 16 Badal S, Thapa Bajgain K, Badal S, Thapa R, Bajgain BB, Santana MJ. Prevalence, clinical characteristics, and outcomes of pediatric COVID-19: a systematic review and meta-analysis. J Clin Virol 2021; 135: 104715
    CrossrefPubMedGoogle Scholar
  • 17 She J, Liu L, Liu W. COVID-19 epidemic: disease characteristics in children. J Med Virol 2020; 92 (07) 747-754
    CrossrefPubMedGoogle Scholar
  • 18 Leung C. Clinical characteristics of COVID-19 in children: are they similar to those of SARS?. Pediatr Pulmonol 2020; 55 (07) 1592-1597
    CrossrefPubMedGoogle Scholar
  • 19 Öztürk GK, Beken B, Doğan S, Akar HH. Pulmonary function tests in the follow-up of children with COVID-19. Eur J Pediatr 2022; 181 (07) 2839-2847
    CrossrefPubMedGoogle Scholar
  • 20 Ferraro VA, Zanconato S, Carraro S. Impact of COVID-19 in children with chronic lung diseases. Int J Environ Res Public Health 2022; 19 (18) 11483
    CrossrefPubMedGoogle Scholar
  • 21 Du H, Dong X, Zhang JJ. et al. Clinical characteristics of 182 pediatric COVID-19 patients with different severities and allergic status. Allergy 2021; 76 (02) 510-532
    CrossrefPubMedGoogle Scholar
  • 22 Shi T, Pan J, Katikireddi SV. et al; Public Health Scotland and the EAVE II Collaborators. Risk of COVID-19 hospital admission among children aged 5-17 years with asthma in Scotland: a national incident cohort study. Lancet Respir Med 2022; 10 (02) 191-198
    CrossrefPubMedGoogle Scholar
  • 23 Bellino S, Punzo O, Rota MC. et al; COVID-19 WORKING GROUP. COVID-19 disease severity risk factors for pediatric patients in Italy. Pediatrics 2020; 146 (04) e2020009399
    CrossrefPubMedGoogle Scholar
  • 24 Moeller A, Thanikkel L, Duijts L. et al. COVID-19 in children with underlying chronic respiratory diseases: survey results from 174 centres. ERJ Open Res 2020; 6 (04) 00409-02020
    CrossrefPubMedGoogle Scholar
  • 25 Kosmeri C, Koumpis E, Tsabouri S, Siomou E, Makis A. Hematological manifestations of SARS-CoV-2 in children. Pediatr Blood Cancer 2020; 67 (12) e28745
    CrossrefPubMedGoogle Scholar
  • 26 Stanton BA, Hampton TH, Ashare A. SARS-CoV-2 (COVID-19) and cystic fibrosis. Am J Physiol Lung Cell Mol Physiol 2020; 319 (03) L408-L415
    CrossrefPubMedGoogle Scholar
  • 27 Al Yazidi LS, Al Maskari N, Al Reesi M. Children with cystic fibrosis hospitalised with COVID-19: multicentre experience. J Paediatr Child Health 2021; 57 (05) 767-768
    CrossrefPubMedGoogle Scholar