A multinational report on SARS-CoV-2 infection outcomes in people with CF and Aspergillus infection or ABPA.

Autor: Bradbury JD; MRC Centre for Medical Mycology, University of Exeter, EX4 4QD, UK; Department of Pharmacology, University of Oxford, OX1 3QT, UK., Chesshyre E; MRC Centre for Medical Mycology, University of Exeter, EX4 4QD, UK; Department of Paediatrics, Royal Devon University Healthcare NHS Foundation Trust, EX2 5DW, UK., Orenti A; Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Biometry and Epidemiology G.A. Maccacaro, University of Milan, Milan 20122, Italy., Jung A; Paediatric Pulmonology, University Children's Hospital Zurich, Ramistrasse 102, Stadtkreis 7 8006, Zurich, Switzerland., Warris A; MRC Centre for Medical Mycology, University of Exeter, EX4 4QD, UK; Department of Paediatric Infectious Diseases, Great Ormond Street Hospital, London, WC1N 3JH, UK.
Jazyk: angličtina
Zdroj: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2024 Mar; Vol. 23 (2), pp. 354-363. Date of Electronic Publication: 2023 Nov 03.
DOI: 10.1016/j.jcf.2023.10.017
Abstrakt: Background: Aspergillus infection is known to be associated with worse respiratory outcomes in people with CF (pwCF) and is a well-recognised complication of severe SARS-CoV-2 infection. The aim of this observational cross-sectional study was to examine the association of pre-existing Aspergillus infection and/or allergic bronchopulmonary aspergillosis (ABPA) in pwCF and severity of COVID-19.
Methods: Data on SARS-CoV-2 infections in pwCF from January 2020 to June 2021 were collected by the European Cystic Fibrosis Society Patient Registry. The primary outcome was COVID-19 severity measured by hospitalisation comparing those with Aspergillus infection and/or ABPA in the 12 months preceding COVID-19 and those without.
Results: In total, 1095 pwCF were diagnosed with SARS-CoV-2 and information on pre-existing Aspergillus/ABPA status was available from 807. PwCF and SARS-CoV-2 in the Aspergillus/ABPA group (n = 153), in comparison to the non-Aspergillus/ABPA group (n = 654), were more likely to be hospitalised (adjusted OR 1.79 (1.19 to 2.85); p = 0.005) and their disease course was more likely to be complicated by sepsis (adjusted OR 7.78 (1.78 to 49.43); p = 0.008). The association with hospital admission was no longer significant after excluding patients with ABPA. Secondary analysis comparing pwCF who received antifungal treatment (n = 18), versus those who did not (n = 474) during COVID-19, showed a higher rate of hospitalisation (p < 0.001); intensive care unit admission (p < 0.001), and requirement for invasive ventilation (p < 0.001) in the antifungal treated group.
Conclusion: We show that pre-existing Aspergillus/ABPA is associated with increased rates of hospitalisation and sepsis during COVID-19 in pwCF.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier B.V.)
Databáze: MEDLINE
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