SARS-CoV-2 infection in a pediatric patient with cystic fibrosis

Abstract

Background: Cystic fibrosis (CF) is a potentially mortal disease characterized by a chronic pulmonary disease with persistent airway infection. Children with this disease are more susceptible to respiratory infections due to the limitation in mucociliary transport and anatomical disruption of the bronchial tree. SARS-CoV-2 causes COVID-19, a respiratory illness related to exacerbations of chronic pulmonary pathologies in children, such as CF and asthma. There are not enough case reports on pediatric patients with SARS-CoV-2 infection and CF, for which we share our experience. Case report: A 22-month-old male patient diagnosed with CF presented in the hospital with cough, fever, and increased respiratory work. The patient received supplemental oxygen and antibiotic and antiviral therapy. Positive results for type B influenza and RT-PCR (reverse transcription-polymerase chain reaction) for SARS-CoV-2 were obtained. Due to the persistence of respiratory difficulty, high-flow therapy was initiated, with a good response. After an episode of hypoxemia, bradycardia, and increased respiratory work secondary to accumulated secretions, orotracheal intubation and invasive mechanical ventilation were performed. The patient evolved with clinical and gasometric improvement. After 10 days of in-hospital antibiotic management with adequate clinical evolution, the patient was discharged to complete oral treatment and home isolation. Conclusions: We present a case of chronic respiratory disease and SARS-CoV-2 infection with severity criteria in a pediatric patient. The evolution was favorable with timely support management and antibiotic therapy in a third-level hospital.

Epidemiological Profile of Hospitalized Patients with Cystic Fibrosis in Brazil Due to Severe Acute Respiratory Infection during the COVID-19 Pandemic and a Systematic Review of Worldwide COVID-19 in Those with Cystic Fibrosis

“…A total of 31 papers published as observational studies reported an association of COVID-19 in patients with CF [ 18 , 19 , 20 , 21 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ] ( Table 1 ). These studies comprised 661,386 patients in total, including children, adults, and elderly age groups.…”

“…However, only 19,150 (2.9%) patients were diagnosed with CF and, from these patients, 2523 (0.4%) were diagnosed with both CF and COVID-19. Regarding patients with CF and COVID-19, the sex proportion was (female/male) 1207/1167 [ 24 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 41 , 42 , 43 , 45 , 47 , 48 , 49 , 50 ]. Some publications [ 21 , 26 , 35 , 40 , 46 ] did not report the sex of the patients.…”

“…The most frequent symptom was fever, reported in 620 patients with CF [ 19 , 20 , 24 , 30 , 31 , 33 , 34 , 35 , 37 , 41 , 43 , 46 , 47 , 50 ], followed by cough (549 patients with CF) [ 24 , 31 , 33 , 34 , 41 , 42 , 46 , 47 , 50 ], and pulmonary symptoms (409 patients with CF) [ 33 , 34 ].…”

II Jornada Integrada da Faculdade Santa Maria

“…Porém, a infecção pode apresentar apenas uma doença de grau leve em alguns casos rinofaringite viral -resfriado (PECKHAM et al, 2020;PÁEZ-VELÁSQUEZ et al, 2021).…”

“…O primeiro caso relatado da doença pelo coronavírus surgiu na cidade de Wuhan, na China, no dia 31 de dezembro de 2019, e rapidamente esse vírus se proliferou, acarretando uma pandemia. Os coronavírus fazem parte da família Coronaviridae e possuem elevada habilidadede transformação e rearranjo genético (PÁEZ-VELÁSQUEZ et al, 2021).…”