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3. Clinical course and risk factors for severe COVID-19 among Italian patients with cystic fibrosis: a study within the Italian Cystic Fibrosis Society

Author

Carla, Colombo, Marco, Cipolli, Valeria, Daccò, Paola, Medino, 1 Federico Alghisi, 4 Maura Ambroni, 5 Raffaele Badolato, 6 Fiorella Battistini, 5 Elisabetta Bignamini, 7 Rosaria Casciaro, 8 Fabiana Ciciriello, 4 Mirella Collura, 9 Isabella Comello, 10 Michela Francalanci, 11 Francesca Ficili, 9 Anna Folino, Leonardi, Salvatore, 12 Giuseppina Leonetti, 13 Maria Cristina Lucanto, 14 Francesca Lucca, 3 Massimo Maschio, 15 Valeria Mencarini, 16 Barbara Messore, 17 Giovanna Pisi, 18 Giovanna Pizzamiglio, 19 Piercarlo Poli, 6 Valeria Raia, 20 Luca Riberi, 17 Mirco Ros, 10 Novella Rotolo, 12 Angela Sepe, 20 Giovanni Taccetti, 11 Pamela Vitullo, 21 and Gianfranco Alicandro1, 2, Colombo, C, Cipolli, M, Daccò, V, Medino, P, Alghisi, F, Ambroni, M, Badolato, R, Battistini, F, Bignamini, E, Casciaro, R, Ciciriello, F, Collura, M, Comello, I, Francalanci, M, Ficili, F, Folino, A, Leonardi, S, Leonetti, G, Lucanto, Mc, Lucca, F, Maschio, M, Mencarini, V, Messore, B, Pisi, G, Pizzamiglio, G, Poli, P, Raia, V, Riberi, L, Ros, M, Rotolo, N, Sepe, A, Taccetti, G, Vitullo, P, and Alicandro, G.

Subjects
Microbiology (medical), Original Paper, Pandemic, SARS-CoV-2, COVID-19, General Medicine, Cystic fibrosis, Infectious Diseases, Italy, Risk Factors, Cystic fibrosi, Humans, Exocrine Pancreatic Insufficiency, Prospective Studies
Abstract

Purpose To describe the clinical course of COVID-19 in patients with cystic fibrosis (CF) and to identify risk factors for severe COVID-19. Methods We conducted a prospective study within the Italian CF Society. CF centers collected baseline and follow-up data of patients with virologically confirmed SARS-CoV-2 infection between March 2020 and June 2021. Odds ratios (ORs) for severe SARS-CoV-2 (as defined by hospital admission) were estimated by logistic regression models. Results The study included 236 patients with positive molecular test for SARS-CoV-2. Six patients died, 43 patients were admitted to hospital, 4 admitted to intensive care unit. Pancreatic insufficiency was associated with increased risk of severe COVID-19 (OR 4.04, 95% CI 1.52; 10.8). After adjusting for age and pancreatic insufficiency, forced expiratory volume in one second (FEVp)

Published
2021

4. A Peculiar Case of Pneumonia due to Mycoplasma pneumoniae in a Child with Cystic Fibrosis and Sensibilization to Aspergillus fumigatus .

Author

Peccini L, Pennoni S, Mencarini V, Saponara M, Palladino N, Principi N, Pennoni G, and Esposito S

Abstract

Aspergillus fumigatus plays a major role in pulmonary exacerbations in patients with cystic fibrosis. The most common A. fumigatus diseases are those based on immune-mediated response to A. fumigatus antigens; including allergic bronchopulmonary aspergillosis (ABPA). In this condition; the presence of A. fumigatus in the lower respiratory tract triggers an IgE-mediated hypersensitivity response that causes airway inflammation; bronchospasms; and bronchiectasis. This case report describes a ten-year-old male patient suffering from cystic fibrosis (CF) in whom the diagnosis of ABPA occurred in association with pneumonia due to Mycoplasma pneumoniae more than two weeks after hospitalization. This case is a good example of how difficult the identification of ABPA in CF patients can be and highlights that ABPA can occur in association with co-infections due to other pathogens. In order to avoid the risk of a late ABPA diagnosis, it is imperative that the diagnostic criteria guidelines are reviewed and standardized., Competing Interests: The authors declare no conflict of interest.

Published
2019
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5. Antimicrobial Treatment of Staphylococcus aureus in Patients With Cystic Fibrosis.

Author

Esposito S, Pennoni G, Mencarini V, Palladino N, Peccini L, and Principi N

Abstract

Staphylococcus aureus is a ubiquitous human commensal pathogen. It is commonly isolated in cystic fibrosis (CF) patients and is considered one of the main causes of the recurrent acute pulmonary infections and progressive decline in lung function that characterize this inherited life-threatening multisystem disorder. However, the true role of S. aureus in CF patients is not completely understood. The main aim of this narrative review is to discuss the present knowledge of the role of S. aureus in CF patients. Literature review showed that despite the fact that the availability and use of drugs effective against S. aureus have coincided with a significant improvement in the prognosis of lung disease in CF patients, clearly evidencing the importance of S. aureus therapy, how to use old and new drugs to obtain the maximal effectiveness has not been precisely defined. The most important problem remains that the high frequency with which S. aureus is carried in healthy subjects prevents the differentiation of simple colonization from infection. Moreover, although experts recommend antibiotic administration in CF patients with symptoms and in those with persistent detection of S. aureus , the best antibiotic approach has not been defined. All these problems are complicated by the evidence that the most effective antibiotic against methicillin-resistant S. aureus (MRSA) cannot be used in patients with CF with the same schedules used in patients without CF. Further studies are needed to solve these problems and to assure CF patients the highest level of care.

Published
2019
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