key: cord-0739903-8q1o8vmd
authors: Padoan, Rita; Salvatore, Marco
title: To the Editor of Journal of Cystic Fibrosis: First and second wave of SARS-CoV2 in Italian Cystic Fibrosis patients: data from Italian Cystic Fibrosis Registry
date: 2021-01-26
journal: J Cyst Fibros
DOI: 10.1016/j.jcf.2021.01.008
sha: ffcb1933f13b4506123fb12cc6cb9482b089235c
doc_id: 739903
cord_uid: 8q1o8vmd

nan

In February 2020, the first case of SARS-CoV2 infection was recognized in Italy, in the Lombardy Region. Within the same Region, an infant identified through Cystic Fibrosis (CF) newborn screening was considered to be the first Italian case of SARS-CoV-2 infection in CF population: he was asymptomatic and probably was infected within his family by his grandfather. [1] Very recently, the international Cystic Fibrosis Registry Global Harmonization Group published in this Journal interesting data on the clinical characteristics and outcomes of SARS-Cov-2 infection in CF patients. [2] With this letter we would like to share the experience of the Italian Cystic Fibrosis Registry (ICFR) by reporting the results of a survey project we have been experiencing since March 2020 thus contributing to the knowledge of the SARS-CoV2 pandemic in CF patients.

In March 2020, the ICFR launched a survey based on a web form fillable by PC, smartphone and tablet for the anonymous collection of data on patients infected with Covid-19, in order to follow-up trends in this particular cohort of patients. All CF Centres (Italian Law 548/93) that usually provide data to the ICFR (total number of Centres = 29, total number of patients included within the ICFR = 5501) were invited to fill in the form monthly, and the few following anonymous data were collected: number of infected subjects, predominant sex, average age of patients, method for SARS-CoV2 diagnosis (nasopharyngeal swab and real time PCR, serology), type of containment, need for hospitalization in the intensive care unit, number of recovered patients when sending the questionnaire.

In the period February -November a total of 87 CF patients resulted positive to SARS-Cov-2 infection; these patients were followed in 19 different Centres (19/29 = 65,5%); their distribution per month is shown in figure 1 (last update 17 December 2020). During the first wave (February to August 2020) only 22 CF patients were positive to SARS-CoV-2 virus and the percentage of infected patients was 0.40% (0.23-0.57 CI95%). No SARS-CoV2 case was reported in July and only one case was reported in August. This low incidence suggested that CF itself could be a protective factor with respect to SARS-CoV2. [3, 4] Probably this incidence, during the first wave, was due to an earlier distancing implemented in CF families, and it reflects better adherence to social distancing and masking than no CF people. [5] , suggesting that at least infection control practices, already implemented by CF patients, may be partly protecting them also from SARS-CoV2 infection.

Interestingly, during the first pandemic wave the majority of patients were reported by the CF Centres operating in Northern Italy; conversely, during the second wave patients were mainly from the South Regions (e.g. 66,6% in November). This data is perfectly in line with that from general from September to November. [5] All patients included in the results from the survey were tested by nasopharyngeal swab and real time PCR except for two cases referred to patients positive to serology test. This simple tool proved to be handy, easy and quick to compile, and thanks to the monthly report, it allowed us to follow the trend of the SARS-CoV2 epidemic in the Italian CF population.

From middle November 2020 a dedicated Covid-19 folder has been also included within the ICFR after adopting the data protection officer (DPO) privacy indications; this inclusion will facilitate a standardized and a more accurate collection of data in accordance with ICFR annual report. 

Aknowledgement: We should like to thank the CF Centres Directors who provided the monthly data

Asymptomatic case of

Covid-19 in an infant with cystic fibrosis

The global impact of SARS-CoV-2 in 181 people with cystic fibrosis

Does cystic fibrosis constitute an advantage in COVID-19 infection?

Sars-CoV-2 infection in patients with cystic fibrosis. An overview

Task force COVID-19 del Dipartimento Malattie Infettive e Servizio di Informatica