COVID-19 pandemic impacted care of patients with cystic fibrosis in US

While in-person visits for patients with cystic fibrosis decreased from 2019 to 2020 during the COVID-19 pandemic, a new study found no evidence of worse lung disease, nutrition or increased risk for pulmonary exacerbations.

“The CF Foundation recommends frequent clinical encounters to monitor for progression of lung disease, surveillance of respiratory microbiology and monitoring for cystic fibrosis-related complications. During the spring [2020] peak of the pandemic, this monitoring was disrupted. The impact of changes in care for people with cystic fibrosis may not be known for some time,” Don B. Sanders, MD, MS, associate professor in the department of pediatrics at Indiana University School of Medicine, Indianapolis, and colleagues wrote in Annals of the American Thoracic Society.

Sanders and colleagues compared changes in BMI and FEV₁ percent predicted and risk for pulmonary exacerbations between patients with cystic fibrosis enrolled in the CF Foundation Patient Registry who had at least one in-person clinic visit in the spring of 2019 and 2020.

In-person clinic visits for patients with cystic fibrosis decreased from 91% in 2019 to 9% in April 2020.

Among patients with cystic fibrosis seen in-person during spring 2019 and 2020, mean FEV₁ percent predicted was 1.3 higher in 2020 for children with cystic fibrosis aged 6 to 11 years and 7.5 higher in 2020 among patients with cystic fibrosis aged 12 years and older who were eligible for elexacaftor/tezacaftor/ivacaftor therapy (Trikafta, Vertex Pharmaceuticals). The researchers reported no difference in FEV₁ percent predicted over time for patients with cystic fibrosis aged 12 years and older who were not eligible for elexacaftor/tezacaftor/ivacaftor.

The mean BMI percentile was 2.4 kg/m² higher in 2020 among children aged 6 to 11 years and 5.2 kg/m² higher in 2020 among those aged 12 to 17 years who were eligible for elexacaftor/tezacaftor/ivacaftor. Mean BMI was 1.2 kg/m² higher among adults with cystic fibrosis who were eligible for elexacaftor/tezacaftor/ivacaftor and 0.2 kg/m² higher among adults not eligible for triple therapy.

Researchers also noted that the proportion of in-person clinic visits with any pulmonary exacerbations were lower in 2020 compared with 2019 (25% vs. 38%).

“CF centers are rapidly adapting to care during the COVID-19 pandemic, and the lessons learned during this time can be used to promote the health of people with cystic fibrosis in the future,” the researchers wrote.