Reduction of pulmonary exacerbations in young children with cystic fibrosis during the COVID‐19 pandemic

Patel, Shreya; Thompson, Misty; Slaven, James E.; Sanders, D.B.; Ren, Clement L.

doi:10.1002/ppul.25250

Cited by 32 publications

(21 citation statements)

References 11 publications

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“…During the COVID-19 pandemic, there was a significant decrease in exacerbations and hospitalizations, 113 likely as a result of the use of barrier measures and the reduction of other viral infections. Nevertheless, rapid changes were required in the healthcare systems 114 to prevent these patients from being exposed to the virus.…”

Section: Cystic Fibrosismentioning

confidence: 99%

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

Chiner-Vives

Cordovilla-Pérez

Rosa-Carrillo

et al. 2022

Archivos de Bronconeumología

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Section: Cystic Fibrosismentioning

confidence: 99%

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

Chiner-Vives

Cordovilla-Pérez

Rosa-Carrillo

et al. 2022

Archivos de Bronconeumología

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“…As we have seen, during the COVID-19 era, in addition to a decrease in bacterial and viral infections due to home isolation, flu vaccination, mask use, and handwashing (33)(34)(35), was an increase in environmental stressors that produced adverse effects in parents and their children with both typical development and neurodevelopmental disorders (36). Also, for PANS/PANDAS to prepare therapeutic interventions, we should consider these environmental factors to produce the flare-up of symptoms.…”

Section: Psychological Condition In Children and Adolescents During The Pandemicmentioning

confidence: 99%

The Impact of the COVID-19 Epidemic During the Lockdown on Children With the Pediatric Acute-Onset Neuropsychiatric Syndrome (PANDAS/PANS): The Importance of Environmental Factors on Clinical Conditions

et al. 2021

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Introduction: In March 2020, SARS-CoV-2 declared a pandemic by the World Health Organization. Restrictive isolation measures have also brought psychological distress to the pediatric population. Building on the syndrome's characteristics, the present study explored the impact of lockdown on the clinical course of young people with PANDAS/PANS. The initial hypothesis considered both the reduced exposure to viral agents and the strategies of the parents and other containment actions as protective factors against the worsening of symptoms.Methods: One hundred and eight children, adolescents, and young adults were recruited according to the multicenter PANDAS/PANS research program. Parents participated in a web-based survey. Results: contrary to our hypothesis, the study results show an increase in symptoms during the block in 71% of the sample. Psychometric analyzes allowed us to exclude a relationship between the main symptoms of PANDAS and the increase in symptoms or the presence of symptoms before the block and their increase over time. The increase in symptoms is best explained by the presence of sleep disturbances and emotional lability. The exacerbation also appears to be linked to the onset of new symptoms in children and adolescents with depressed moods and eating problems. Furthermore, irritability and oppositionality are significant predictors of acute exacerbation. Equally statistically significant is the factor linked to the effects of pandemic stress, such as the fear of contracting the virus. No significant associations for symptom reduction have been identified between parental strategies or other parent-initiated actions, but the study demonstrates that caregiver perceived efficacy on the strategies used can reduce the risk of exacerbation.Conclusion: This preliminary study highlights the importance of studying the causes of increased symptoms in children with PANDAS/PANS. Life events can exacerbate the clinical condition or generate new symptoms in young patients. In particular, environmental, family, and social changes in the course of clinical symptoms in PANDAS/PANS patients should be investigated. It highlights the importance of emotional and behavioral management, which can be improved by enhancing coping strategies in young people with PANDAS/PANS and their caregivers through a combination treatment in which CBT and PMT are included, in line with guidelines.Limits: An experimental proxy-report questionnaire not yet standardized and validated on the PANS/PANDAS pediatric clinical sample was used for the exploratory study. There is also a small sample size (N = 108) and the absence of a control group (pre-lockdown or children without PANDAS/PANS). It would be interesting to evaluate the exact long-term dimensions to see the course of symptoms after covid and conduct a new study focusing on the impact of stressful events on the clinical course of the syndrome.

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“…This may have resulted in missed reports of PEx, but PEx treated via phone and/or telemedicine encounters may not contribute significantly to PEx treatments during the pandemic. (35) The CFFPR does not capture potential causes for the reduction in PEx, e.g, avoidance of viral infections, or improved adherence to chronic therapies during stay at-home orders. It is possible that improvements in 2020 may in part be attributed to (1) healthier pwCF attending in-person clinic visits during the spring 2020 peak of the pandemic, and/or (2) in-person clinic visits that occurred as part of the ETI initiation process and/or for monitoring of laboratory values while initiating ETI.…”

Section: Discussionmentioning

confidence: 99%

Changes in Care during the COVID-19 Pandemic for People with Cystic Fibrosis

Sanders

O'Neil

et al. 2022

Annals ATS

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Rationale: Cystic Fibrosis (CF) Centers transitioned to telemedicine during the Spring 2020 peak of the COVID-19 pandemic.Objectives: We hypothesized that people with CF (pwCF) with more severe disease would be more likely to be seen in-person. Methods:We used paired t-tests to compare within-subject changes in BMI and percent predicted forced expiratory volume in one second (FEV 1 ), and calculated relative risk (RR) to compare pulmonary exacerbations (PEx) between pwCF enrolled in the CF Foundation Patient Registry with at least one in-person clinic visit after March 15 in both 2019 and 2020.Results: Overall, the proportion of clinical encounters that were in-person clinic visits decreased from 91% in 2019 to a low of 9% in April, 2020. Among pwCF seen after March 15 in both 2019 and 2020, the mean (95% CI) FEV 1 % predicted was 1.3 (0.1, 2.4)% predicted higher in 2020 for children 6-<12 years of age, and 7.5 (7.1, 7.9)% predicted higher in 2020 among pwCF 12 years of age eligible for the highly effective CFTR modulator, elexacaftor-tezacaftor-ivacaftor (ETI).There was no difference in FEV 1 % predicted for pwCF 12 years of age who were not eligible for ETI. Similarly, the mean (95% CI) BMI percentile was 2.4 (2.0, 2.8) higher in 2020 for children 6-<12 years of age, and 5.2 (4.8, 5.7) higher in 2020 among children 12-<18 years of age eligible for ETI. Mean (95% CI) BMI (kg/m 2 ) was 1.2 (1.2, 1.3) higher for pwCF 18 years of age eligible for ETI, and 0.2 (0.1, 0.3) higher for pwCF 18 years of age not eligible for ETI. The proportion of in-person clinic visits where any PEx was present was lower in 2020 compared with 2019, 25% as compared to 38%, RR 0.82 (0.79, 0.86).

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Reduction of pulmonary exacerbations in young children with cystic fibrosis during the COVID‐19 pandemic

Cited by 32 publications

References 11 publications

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

The Impact of the COVID-19 Epidemic During the Lockdown on Children With the Pediatric Acute-Onset Neuropsychiatric Syndrome (PANDAS/PANS): The Importance of Environmental Factors on Clinical Conditions

Changes in Care during the COVID-19 Pandemic for People with Cystic Fibrosis

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