1887
  1. Home
  2. A-Z Publications
  3. Qatar Medical Journal
  4. Volume 2023, Issue 3
  5. Article
Volume 2023, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: SARS-CoV-2 in children with cystic fibrosis (CF) has been reported to cause mild illness without pre-existing severe lung disease. This review described the clinical presentation and course of COVID-19 infection in children with CF in Qatar.

Methods: The pediatric CF registry of 51 patients in Qatar was reviewed for COVID-19 cases from February 2020 to February 2022. Demographics, vaccination status, symptoms, and course were reviewed. Data were expressed as median, range, frequencies, and percentages.

Results: The study included eight patients with CF below 18 years of age infected with COVID-19. The incidence of COVID-19 in children with CF was 15.7%. The median age was 11 (2-18) years. Half of the cohort were males. Seven patients were pancreatic sufficient (I1234V mutation), and one was pancreatic insufficient (3129del4 mutation). The median baseline FEV1 was 91 (78-107%) predicted. None had received CFTR modulators or undergone a lung transplant. Three patients were vaccinated before their infections. Two of them were asymptomatic. Six patients (75%) had a cough and flu-like symptoms. Three patients had a fever. Two patients were hospitalized due to pulmonary exacerbation; both had mild CF-lung disease. None required respiratory support.

Conclusion: We report a favorable outcome of COVID-19 infection in children with CF, similar to published international studies. Our findings are attributable to the community-dominant milder CFTR mutation, precautionary measures, and causative COVID-19 strain. More longitudinal data are needed to study these factors as potential protective mechanisms.

© 2023 Hamad, Kammouh, Alamri, Zahraldin, licensee HBKU Press.
Loading

Article metrics loading...

/content/journals/10.5339/qmj.2023.19
2023-09-01
2024-11-09
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2023/3/qmj.2023.19.html?itemId=/content/journals/10.5339/qmj.2023.19&mimeType=html&fmt=ahah

References

  1. Elborn JS. Cystic fibrosis. Lancet. 2016; 388:(10059):2519–31.
     [Google Scholar]
  2. O’Sullivan BP, Freedman SD. Cystic fibrosis. Lancet. 2009 May 30; 373:(9678):1891–904.
     [Google Scholar]
  3. Banjar H, Angyalosi G. The road for survival improvement of cystic fibrosis patients in Arab countries. Int J Pediatr Adolesc Med. 2015 Jun 1; 2:(2):47–58.
     [Google Scholar]
  4. Hammoudeh S, Gadelhaq W, Hani Y, Omar N, El Dimassi D, Elizabeth C, et al. The epidemiology of cystic fibrosis in Arab countries: A systematic review. SN Compr Clin Med. 2021 Feb; 3:(2):490–8.
     [Google Scholar]
  5. World Health Organization . Report of a Joint WHO/ICF (M) A meeting on the distribution of cystic fibrosis, Nicosia, Cyprus. WHO; 1985.
     [Google Scholar]
  6. Wahab AA, Janahi IA, Hebi S, Al-Hamed M, Kambouris M. Cystic fibrosis in a child from Syria. Ann Trop Paediatr. 2002 Mar 1; 22:(1):53–5.
     [Google Scholar]
  7. Wahab A, Al Thani G, Dawod ST, Kambouris M, Al Hamed M. Rare CFTR mutation 1525-1G> A in a Pakistani patient. J Trop Pediatr. 2004 Apr 1; 50:(2):120–2.
     [Google Scholar]
  8. Wahab AA, Janahi IA, Marafia MM. An Egyptian infant with cystic fibrosis mutation N1303K. Qatar Med J. 2004 Jun 1; 2004:(1):16.
     [Google Scholar]
  9. Wahab AA, Janahi IA, Marafia MM. Pseudo-Bartter’s syndrome in an Egyptian infant with cystic fibrosis mutation N1303K. J Trop Pediatr. 2004 Aug 1; 50:(4):242–4.
     [Google Scholar]
  10. Wahab AA, Al Thani G, Dawod ST, Kambouris M, Al Hamed M. Heterogeneity of the cystic fibrosis phenotype in a large kindred family in Qatar with cystic fibrosis mutation (I1234V). J Trop Pediatr. 2001 Apr 1; 47:(2):110–2.
     [Google Scholar]
  11. Rahman HA, Wahab AA, Rahman MOA, Mostafa OAR. Fecal elastase‐1 concentration in cystic fibrosis patients with CFTR I1234V mutation. Acta Paediatr. 2006 Sep; 95:(9):1066–9.
     [Google Scholar]
  12. Wark PAB, Tooze M, Cheese L, Whitehead B, Gibson PG, Wark KF, et al. Viral infections trigger exacerbations of cystic fibrosis in adults and children. Eur Respir J. 2012 Aug 1; 40:(2):510–2.
     [Google Scholar]
  13. Somayaji R, Goss CH, Khan U, Neradilek M, Neuzil KM, Ortiz JR. Cystic fibrosis pulmonary exacerbations attributable to respiratory syncytial virus and influenza: A population-based study. Clin Infect Dis. 2017 Jun 15; 64:(12):1760–7.
     [Google Scholar]
  14. Zheng S, De BP, Choudhary S, Comhair SAA, Goggans T, Slee R, et al. Impaired innate host defense causes susceptibility to respiratory virus infections in cystic fibrosis. Immunity. 2003 May 1; 18:(5):619–30.
     [Google Scholar]
  15. Manti S, Parisi GF, Papale M, Mulè E, Aloisio D, Rotolo N, et al. Cystic fibrosis: Fighting together against coronavirus infection. Front Med. 2020 June 9; 7::307.
     [Google Scholar]
  16. Sutanto EN, Kicic A, Foo CJ, Stevens PT, Mullane D, Knight DA, et al.; Australian Respiratory Early Surveillance Team for Cystic Fibrosis. Innate inflammatory responses of pediatric cystic fibrosis airway epithelial cells: effects of nonviral and viral stimulation. Am J Respir Cell Mol Biol. 2011 June; 44:(6):761–7.
     [Google Scholar]
  17. Renk H, Regamey N, Hartl D. Influenza A (H1N1) pdm09 and cystic fibrosis lung disease: A systematic meta-analysis. PLoS ONE. 2014 Jan 10; 9:(1):e78583.
     [Google Scholar]
  18. Viviani L, Assael BM, Kerem E; ECFS (A) H1N1 study group. Impact of the A (H1N1) pandemic influenza (season 2009–2010) on patients with cystic fibrosis. J Cyst Fibros. 2011 Sep 1; 10:(5):370–6.
     [Google Scholar]
  19. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al.; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020; 382:(8):727–33.
     [Google Scholar]
  20. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395:(10223):497–506.
     [Google Scholar]
  21. Götzinger F, Santiago-García B, Noguera-Julián A, Lanaspa M, Lancella L, Carducci FIC, et al. COVID-19 in children and adolescents in Europe: A multinational, multicentre cohort study. Lancet Child Adolesc Health. 2020 Sep 1; 4:(9):653–61.
     [Google Scholar]
  22. Hoang A, Chorath K, Moreira A, Evans M, Burmeister-Morton F, Burmeister F, et al. COVID-19 in 7780 pediatric patients: A systematic review. EClinicalMedicine. 2020 Jul 1; 24::100433.
     [Google Scholar]
  23. Albitar O, Ballouze R, Ooi JP, Ghadzi SMS. Risk factors for mortality among COVID-19 patients. Diabetes Res Clin Pract. 2020 Aug 1; 166::108293.
     [Google Scholar]
  24. Poli P, Timpano S, Goffredo M, Padoan R, Badolato R. Asymptomatic case of Covid-19 in an infant with cystic fibrosis. J Cyst Fibros. 2020; 19:(3):e18.
     [Google Scholar]
  25. Blanchon S, Fernandez C, Guerin S, Crisinel P-A, Rochat I. COVID-19: A message of hope from a young girl with severe cystic fibrosis. Pediatr Pulmonol. 2020; 55:(7):1546–7.
     [Google Scholar]
  26. Cosgriff R, Ahern S, Bell SC, Brownlee K, Burgel P-R, Byrnes C, et al.; Global Registry Harmonization Group. A multinational report to characterise SARS-CoV-2 infection in people with cystic fibrosis. J Cyst Fibros. 2020; 19:(3):355–8.
     [Google Scholar]
  27. Peckham D, McDermott MF, Savic S, Mehta A. COVID-19 meets Cystic Fibrosis: For better or worse? Genes Immun. 2020; 21::260–2.
     [Google Scholar]
  28. Al Khal A, Al-Kaabi S, Checketts RJ. Qatar’s response to COVID-19 pandemic. Heart Views. 2020 Jul; 21:(3):129–32.
     [Google Scholar]
  29. Colombo C, Burgel P-R, Gartner S, van Koningsbruggen-Rietschel S, Naehrlich L, Sermet-Gaudelus I, et al. Impact of COVID-19 on people with cystic fibrosis. Lancet Respir Med. 2020 May 1; 8:(5):e35–6.
     [Google Scholar]
  30. Al Yazidi LS, Al Maskari N, Al Reesi M. Children with cystic fibrosis hospitalised with Covid‐19: Multicentre experience. J Paediatr Child Health. 2021 May; 57:(5):767–8.
     [Google Scholar]
  31. McClenaghan E, Cosgriff R, Brownlee K, Ahern S, Burgel P-R, Byrnes CA, et al.; Global Registry Harmonization Group. The global impact of SARS-CoV-2 in 181 people with cystic fibrosis. J Cyst Fibros. 2020 Nov 1; 19:(6):868–71.
     [Google Scholar]
  32. Bain R, Cosgriff R, Zampoli M, Elbert A, Burgel P-R, Carr SB, et al. Clinical characteristics of SARS-CoV-2 infection in children with cystic fibrosis: An international observational study. J Cyst Fibros. 2021 Jan 1; 20:(1):25–30.
     [Google Scholar]
  33. Bezzerri V, Lucca F, Volpi S, Cipolli M. Does cystic fibrosis constitute an advantage in COVID-19 infection?. Ital J Pediatr. 2020 Dec; 46:(1):1–3.
     [Google Scholar]
  34. Marcinkiewicz J, Mazurek H, Majka G, Chain B. Are patients with lung cystic fibrosis at increased risk of severe and fatal COVID-19? Interleukin 6 as a predictor of COVID-19 outcomes. Pol Arch Intern Med. 2020; 130:(10):919–20.
     [Google Scholar]
  35. Moore JB, June CH. Cytokine release syndrome in severe COVID-19. Science. 2020 May 1; 368:(6490):473–4.
     [Google Scholar]
  36. Lan J, Ge J, Yu J, Shan S, Zhou H, Fan S, et al. Structure of the SARS-CoV-2 spike receptor-binding domain bound to the ACE2 receptor. Nature. 2020 May; 581:(7807):215–20.
     [Google Scholar]
  37. Ni W, Yang X, Yang D, Bao J, Li R, Xiao Y, et al. Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Crit Care. 2020 Dec; 24:(1):1–0.
     [Google Scholar]
  38. Sarzi-Puttini P, Giorgi V, Sirotti S, Marotto D, Ardizzone S, Rizzardini G, et al. COVID-19, cytokines and immunosuppression: what can we learn from severe acute respiratory syndrome? Clin Exp Rheumatol. 2020 Mar 22; 38:(2):337–42.
     [Google Scholar]
  39. Marson FAL, Bertuzzo CS, Hortencio TDR, Ribeiro JD, Bonadia LC, Ribeiro AF. The ACE gene D/I polymorphism as a modulator of severity of cystic fibrosis. BMC Pulm Med. 2012 Dec; 12:(1):1–8.
     [Google Scholar]
  40. Stanton BA, Hampton TH, Ashare A. SARS-CoV-2 (COVID-19) and cystic fibrosis. Am J Physiol Lung Cell Mol Physiol. 2020 Sep 1; 319:(3):L408–15.
     [Google Scholar]
  41. Mondejar-Lopez P, Quintana-Gallego E, Giron-Moreno RM, Cortell-Aznar I, de Valbuena-Maiz MR, Diab-Caceres L, et al.; CF-COVID19-Spain Registry Group. Impact of SARS-CoV-2 infection in patients with cystic fibrosis in Spain: Incidence and results of the national CF-COVID19-Spain survey. Respir Med. 2020 Aug 1; 170::106062.
     [Google Scholar]
  42. Carmona-Gutierrez D, Bauer MA, Zimmermann A, Kainz K, Hofer SJ, Kroemer G, et al. Digesting the crisis: Autophagy and coronaviruses. Microb Cell. 2020 May 4; 7:(5):119–28.
     [Google Scholar]
  43. Okur HK, Yalcin K, Tastan C, Demir S, Yurtsever B, Karakus GS, et al. Preliminary report of in vitro and in vivo effectiveness of dornase alfa on SARS-CoV-2 infection. New Microbes New Infect. 2020 Sep 1; 37::100756.
     [Google Scholar]
  44. Corvol H, de Miranda S, Lemonnier L, Kemgang A, Gaubert MR, Chiron R, et al. First wave of COVID-19 in French patients with cystic fibrosis. J Clin Med. 2020 Nov 10; 9:(11):3624.
     [Google Scholar]
  45. Moeller A, Thanikkel L, Duijts L, Gaillard EA, Garcia-Marcos L, Kantar A, et al. COVID-19 in children with underlying chronic respiratory diseases: Survey results from 174 centres. ERJ Open Res. 2020 Oct 1; 6:(4):00409–2020.
     [Google Scholar]
  46. Touret F, Gilles M, Barral K, Nougairède A, van Helden J, Decroly E, et al. In vitro screening of a FDA approved chemical library reveals potential inhibitors of SARS-CoV-2 replication. Sci Rep. 2020 Aug 4; 10:(1):1–8.
     [Google Scholar]
  47. Ghazy RM, Almaghraby A, Shaaban R, Kamal A, Beshir H, Moursi A, et al. A systematic review and meta-analysis on chloroquine and hydroxychloroquine as monotherapy or combined with azithromycin in COVID-19 treatment. Sci Rep. 2020 Dec 17; 10:(1):1–8.
     [Google Scholar]
  48. Pollock J, Chalmers JD. The immunomodulatory effects of macrolide antibiotics in respiratory disease. Pulm Pharmacol Ther. 2021 Dec; 71::102095. https://doi.org/10.1016/j.pupt.2021.102095
     [Google Scholar]
  49. Jung A, Orenti A, Dunlevy F, Aleksejeva E, Bakkeheim E, Bobrovnichy V, et al. Factors for severe outcomes following SARS-CoV-2 infection in people with cystic fibrosis in Europe. ERJ Open Res. 2021 Oct 1; 7:(4):00411–2021.
     [Google Scholar]
  50. Terlizzi V, Motisi MA, Pellegrino R, Padoan R, Chiappini E. Risk factors for severe COVID-19 in people with cystic fibrosis: A systematic review. Front Pediatr. 2022; 10::958658.
     [Google Scholar]
/content/journals/10.5339/qmj.2023.19
Loading
The clinical features and impact of SARS-CoV-2/COVID-19 infection in children with Cystic Fibrosis (CF): A Qatari experience
Qatar Medical Journal 2023, 19 (2023); https://doi.org/10.5339/qmj.2023.19
/content/journals/10.5339/qmj.2023.19
/content/journals/10.5339/qmj.2023.19
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): CF: Cystic Fibrosis, COVID-19: Coronavirus disease 2019 and SARS-CoV-2: severe acute respiratory syndrome coronavirus 2

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error