Highlights
- •We report 130 SARS-CoV-2 cases in people with CF (pwCF) to June 2020 across Europe.
- •Reported incidence was higher in pwCF versus the age-matched general population.
- •pwCF had more hospital and intensive care admissions than the general population.
- •Lung-transplanted pwCF had more severe illness and needed more care.
- •SARS-CoV-2 can cause severe disease in pwCF justifying priority vaccination.
Abstract
Background
Methods
Results
Conclusions
Keywords
1. Background
- Dorjee K
- Kim H
- Bonomo E
- Dolma R.
2. Methods
2.1 Study design
World Health Organization. Public health surveillance for COVID-19.2020. https://www.who.int/publications/i/item/who-2019-nCoV-surveillanceguidance-2020. 7 Date accessed: 23 November 2020.
World Health Organization. Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases.2020. https://www.who.int/publications/i/item/10665-331501. Date accessed: 23 November 2020.
World Health Organization. International guidelines for certification and classification (coding) of Covid-19 as cause of death.2020. https://www.who.int/classifications/icd/Guidelines_Cause_of_Death_COVID-19.pdf?ua=1. Date accessed: 23 November 2020.
ZolinA, OrentiA, NaehrlichL, JungA, van RensJ. ECFS Patient Registry Annual Report 2018. 2020. https://www.ecfs.eu/projects/ecfs-patient-registry/annual-reports
ZolinA, OrentiA, NaehrlichL, JungA, van RensJ. ECFS Patient Registry Annual Report 2018. 2020. https://www.ecfs.eu/projects/ecfs-patient-registry/annual-reports
2.2 Data collected
ZolinA, OrentiA, NaehrlichL, JungA, van RensJ. ECFS Patient Registry Annual Report 2018. 2020. https://www.ecfs.eu/projects/ecfs-patient-registry/annual-reports
Dataset. European Centre for Disease Control.Daily number of new reported cases of COVID-19 by country worldwide.2020. https://www.ecdc.europa.eu/en/publications-data/download-todays-data-geographic-distribution-covid-19-cases-worldwide. Date accessed: 06 Dec 2020.
Dataset. European Centre for Disease Control.Data on hospital and ICU admission rates and current occupancy for COVID-19.2020. https://www.ecdc.europa.eu/en/publications-data/download-data-hospital-and-icu-admission-rates-and-current-occupancy-covid-19. Date accessed: 06 Dec 2020.
European Centre for Disease Control. How ECDC collects and processes Covid-19 data. 2021. https://www.ecdc.europa.eu/en/covid-19/data-collection. Date accessed: 11 Jan 2021.
Dataset. European Centre for Disease Control.Daily number of new reported cases of COVID-19 by country worldwide.2020. https://www.ecdc.europa.eu/en/publications-data/download-todays-data-geographic-distribution-covid-19-cases-worldwide. Date accessed: 06 Dec 2020.
2.3 Statistics
EngelsB. XNomial: Exact Goodness-of-Fit Test for Multinomial Data with Fixed Probabilities. R package version 1.0.4 2015. https://cran.r-project.org/package=XNomial
3. Results
3.1 Participation and patient characteristics

Total N=130 | Non-lung transplant1 N=107 | Lung-transplant N=23 | |
---|---|---|---|
Age, years, n (%) | |||
0-11 | 15 (11.5%) | 15 (14%) | 0 (0%) |
12-17 | 24 (18.5%) | 24 (22.4%) | 0 (0%) |
18-29 | 37 (28.5%) | 33 (30.8%) | 4 (17.4%) |
30-49 | 49 (37.7%) | 30 (28%) | 19 (82.6%) |
50+ | 5 (3.8%) | 5 (4.7%) | 0 (0%) |
Sex, n (%) | |||
Female | 58 (44.6%) | 50 (46.7%) | 8 (34.8%) |
Male | 72 (55.4%) | 57 (53.3%) | 15 (65.2%) |
Genotype, n (%) | |||
F508del homozygous | 57 (43.8%) | 45 (42.1%) | 2 (8.7%) |
F508del heterozygous | 46 (35.4%) | 37 (34.6%) | 9 (39.1%) |
Other | 27 (20.8%) | 25 (23.4%) | 12 (52.2%) |
Unknown | 0 | 0 | 0 |
BMI2, kg/m2, n (%) | |||
<18.5 | 31 (26.3%) | 27 (28.1%) | 4 (18.2%) |
18.5-30 | 82 (69.5%) | 64 (66.7%) | 18 (81.8%) |
>30 | 5 (4.2%) | 5 (5.2%) | 0 (0%) |
Unknown | 8 | 7 | 1 |
Azithromycin (maintenance therapy pre-infection), n (%) | |||
Yes | 30 (39.0%) | 23 (35.4%) | 7 (58.3%) |
No | 47 (61.0%) | 42 (64.6%) | 5 (41.7%) |
Unknown | 53 | 42 | 11 |
ppFEV13, n (%) | |||
≤40% | 31 (26.5%) | 27 (28.4%) | 4 (18.2%) |
41-70% | 31 (26.5%) | 28 (29.5%) | 3 (13.6%) |
>70% | 55 (47.0%) | 40 (42.1%) | 15 (68.2%) |
Unknown | 5 | 4 | 1 |
Pseudomonas aeruginosa4, n (%) | |||
Yes | 65 (51.2%) | 53 (50.5%) | 12 (54.5%) |
No | 62 (48.8%) | 52 (49.5%) | 10 (45.5%) |
Unknown | 3 | 2 | 1 |
CF related diabetes, n (%) | |||
Yes | 40 (32.0%) | 26 (25.2%) | 14 (63.6%) |
No | 85 (68.0%) | 77 (74.8%) | 8 (36.4%) |
Unknown | 5 | 4 | 1 |
Pancreatic insufficiency, n (%) | |||
Yes | 82 (79.6%) | 62 (75.6%) | 20 (95.2%) |
No | 21 (20.4%) | 20 (24.4%) | 1 (4.8%) |
Unknown | 27 | 25 | 2 |
CFTR modulator therapy, n (%) | |||
Yes | 31 (24.6%) | 30 (29.1%) | 1 (4.3%) |
No | 95 (75.4%) | 73 (70.9%) | 22 (95.7%) |
Unknown | 4 | 4 | 0 |
3.2 Symptoms of SARS-CoV-2 infection in pwCF
3.3 Incidence of SARS-CoV-2 infection in pwCF


3.4 Management and outcomes
Total (N=130) | Non-lung transplant N=107 | Lung-transplant N=23 | |
---|---|---|---|
Hospital admission | |||
Yes | 75 (58.1%) | 56 (52.8%) | 19 (82.6%) |
No | 54 (41.9%) | 50 (47.2%) | 4 (17.4%) |
Missing | 1 | 1 | 0 |
Intensive care unit | |||
Yes | 12 (9.2%) | 6 (5.6%) | 6 (26.1%) |
No | 118 (90.8%) | 101 (94.4%) | 17 (73.9%) |
Missing | 0 | 0 | 0 |
Death | |||
Yes | 5 (3.8%) | 2 (1.9%) | 3 (13%) |
No | 125 (96.2%) | 105 (98.1%) | 20 (87%) |
Missing | 0 | 0 | 0 |
4. Discussion
- Mondejar-Lopez P
- Quintana-Gallego E
- Giron-Moreno RM
- Cortell-Aznar I
- Ruiz de Valbuena-Maiz M
- Diab-Caceres L
- et al.
ZolinA, OrentiA, NaehrlichL, JungA, van RensJ. ECFS Patient Registry Annual Report 2018. 2020. https://www.ecfs.eu/projects/ecfs-patient-registry/annual-reports
Dataset. European Centre for Disease Control.Data on testing for COVID-19 by week and country.2020. https://www.ecdc.europa.eu/en/publications-data/covid-19-testing.
- Mondejar-Lopez P
- Quintana-Gallego E
- Giron-Moreno RM
- Cortell-Aznar I
- Ruiz de Valbuena-Maiz M
- Diab-Caceres L
- et al.
- van Koningsbruggen-Rietschel S
- Dunlevy F
- Bulteel V
- Downey DG
- Dupont L.
- van Kasteren PB
- van der Veer B
- van den Brink S
- Wijsman L
- de Jonge J
- van den Brandt A
- et al.
4.1 Disease course and outcomes
- Mondejar-Lopez P
- Quintana-Gallego E
- Giron-Moreno RM
- Cortell-Aznar I
- Ruiz de Valbuena-Maiz M
- Diab-Caceres L
- et al.
- Buitrago-Garcia D
- Egli-Gany D
- Counotte MJ
- Hossmann S
- Imeri H
- Ipekci AM
- et al.
Centers for disease control and prevention (CDC). Evidence used to update the list of underlying medical conditions that increase a person's risk of severe illness from COVID-19. 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/evidence-table.html. Date accessed: 22 December 2020.
ZolinA, OrentiA, NaehrlichL, JungA, van RensJ. ECFS Patient Registry Annual Report 2018. 2020. https://www.ecfs.eu/projects/ecfs-patient-registry/annual-reports
- Raja MA
- Mendoza MA
- Villavicencio A
- Anjan S
- Reynolds JM
- Kittipibul V
- et al.
- Saez-Gimenez B
- Berastegui C
- Barrecheguren M
- Revilla-Lopez E
- Los Arcos I
- Alonso R
- et al.
4.2 Limitations and future directions
- Mondejar-Lopez P
- Quintana-Gallego E
- Giron-Moreno RM
- Cortell-Aznar I
- Ruiz de Valbuena-Maiz M
- Diab-Caceres L
- et al.
ZolinA, OrentiA, NaehrlichL, JungA, van RensJ. ECFS Patient Registry Annual Report 2018. 2020. https://www.ecfs.eu/projects/ecfs-patient-registry/annual-reports
- Mondejar-Lopez P
- Quintana-Gallego E
- Giron-Moreno RM
- Cortell-Aznar I
- Ruiz de Valbuena-Maiz M
- Diab-Caceres L
- et al.
5. Conclusion
Contributors
Belgium
Denmark
France
Germany
Greece
Ireland
Italy
Luxembourg
Russia
Spain
Sweden
Switzerland
Ukraine
Author Statement
Declaration of Competing Interest
Acknowledgements
Appendix. Supplementary materials
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