THE CLINICAL IMPACT OF COVID-19 ON CYSTIC FIBROSIS PATIENTS IN NEW YORK

TOPIC: Genetic and Developmental Disorders TYPE: Original Investigations PURPOSE: Patients with cystic fibrosis (CF) may be at risk of complications from COVID-19 but the impact of the COVID-19 pandemic on patients with CF remains unknown. We conducted a multicenter retrospective cohort study to assess the impact of the COVID-19 pandemic on all patients in 11 New York City metropolitan area CF centers from 3/1/20 to 8/31/20 and to examine the clinical characteristics, management, and outcomes of COVID-19 in patients with CF. METHODS: All patients with CF treated at 11 adult and pediatric CF centers in New York were included in the study. Data was collected from the EMR at each institution. The primary outcomes were (1) prevalence of COVID-19 in the 11 CF centers based on either PCR or IgG antibody positivity, (2) delay in routine outpatient care (composite variable of delay in office visit, blood work, pulmonary function testing, elective invasive procedure, diagnostic imaging, subspecialty follow up, or lung transplant active listing), (3) increase in anxiety or depression during the pandemic as determined by social workers, and (4) number of office or telehealth visits and CF exacerbations during the study period. RESULTS: Among patients with CF treated at the 11 New York CF centers, the prevalence of COVID-19 was 3% (28 of 812). 15 patients tested positive on PCR testing, 19 on IgG antibody testing, and 6 on both. 61% of cases were asymptomatic (17 of 28) and the most common symptoms were cough (32%, 9 of 28), shortness of breath (25%, 7 of 28), fever (21%, 6 of 28), and myalgias (21%, 6 of 28). The majority of all cases (93%, 26 of 28) and symptomatic cases (82%, 9 of 11) were managed at home. 2 patients were hospitalized (7%) and 1 patient, who had a history of lung transplant, died (4%). 89% (25 of 28) of patients did not require treatment, 11% (3 of 28) received antibiotics, 7% (2 of 28) received corticosteroids, and 4% (1/28) received remdesivir. 39% (11 of 28) of COVID-19 positive CF patients were taking a CFTR modulator. During the pandemic 84% of patients (669 of 812) experienced a delay in routine care, 42% (222 of 530) reported new or worsened anxiety, and 26% (126 of 486) reported new or worsened depression. From 3/1/20 to 5/31/20, the number of physician visits decreased by 17% despite the use of telehealth visits and the number of pulmonary exacerbations was 51% lower than the same period the previous year. CONCLUSIONS: The prevalence of COVID-19 in CF patients in New York during the first wave of the pandemic was low and the majority of cases were successfully managed at home. Though the number of pulmonary exacerbations decreased during the pandemic, there was a notable delay in routine care and effect on mental health for CF patients. CLINICAL IMPLICATIONS: Further research is needed to understand the risk of complications from COVID-19 in CF patients, as well as the role played by CFTR modulators and precautions such as mask use and social distancing. DISCLOSURES: No relevant relationships by Robert Abdullah, source=Web Response No relevant relationships by Maria Berdella, source=Web Response No relevant relationships by Lynn Bonitz, source=Web Response No relevant relationships by Rany Condos, source=Web Response No relevant relationships by Andrei Constantinescu, source=Web Response No relevant relationships by Joan DeCelie- Germana, source=Web Response No relevant relationships by Emily Di Mango, source=Web Response No relevant relationships by Christine ESPOSITO, source=Web Response No relevant relationships by Theresa Frantzen, source=Web Response No relevant relationships by Robert Giusti, source=Web Response No relevant relationships by Katherine Henthorne, source=Web Response No relevant relationships by Claire Keating, source=Web Response No relevant relationships by Catherine Kier, source=Web Response No relevant relationships by Geralyn La Vecchia, source=Web Response No relevant relationships by Alison Lennox, source=Web Response No relevant relationships by Ramona Ramdeo, source=Web Response No relevant relationships by Hossein Sadeghi, source=Web Response No relevant relationships by Joseph Simonson, source=Web Response No relevant relationships by Jessica Trentacoste, source=Web Response No relevant relationships by Donna Tsang, source=Web Response No relevant relationships by Patricia Walker, source=Web Response No relevant relationships by Janice Wang, source=Web Response