(48) Longitudinal outcomes of adults and children with cystic fibrosis during the COVID-19 pandemic

Background: The onset of the COVID-19 pandemic was associated with restricted community movement, including limited access to healthcare facilities, resulting in a change in clinical service delivery to people with cystic fibrosis (CF). The aim of this study was to determine clinical outcomes of Australian adults and children with CF in the 12-months following the onset of the COVID-19 pandemic.

Methods: This longitudinal cohort study used prospectively entered national registry data. Primary outcomes were 12-month change in percent predicted forced expiratory volume in one second (FEV1 %pred), body mass index (BMI) in adults and BMI z-scores in children. A piecewise linear mixed-effects model was used to determine trends in outcomes in the 24 months before and 12 months following pandemic onset. In addition, comparative analysis of hospitalization and service delivery data before and after the onset of the pandemic was conducted.

Results: Data were available for 3662 individuals (median age 19.6 years, range 0-82). Overall registry data completeness was 95%. When trends in outcomes before and after pandemic onset were compared; FEV1 %pred went from a mean annual decline of -0.13% (95%CI -0.39 to 0.13) to a mean improvement of 1.73% (95%CI 1.29 to 2.17). Annual trend in BMI improved from 0.01kg/m² (95%CI -0.07 to 0.09) to 0.33kg/m² (95%CI 0.23-0.43). There was no change in BMI z-scores. Number of hospitalizations decreased from a total of 2656 to 1957 (p< 0.01). Virtual outpatient consultations increased from 8% pre-pandemic onset to 47% during the pandemic. There was an increase in average number of consultations per patient from median (IQR) of 4(2-5) to 5(3-6) (p< 0.01).

Conclusions: In the 12-months following the onset of the COVID-19 pandemic, there has been an observed improvement in the clinical outcomes of people with CF and a change in model of care delivery when compared to the pre-pandemic period. Individuals with CF and their healthcare teams will need to consider how best to deliver care in light of improved outcomes observed during the COVID-19 pandemic.

Acknowledgements: This study was kindly supported by a Health Service Research Grant from the HCF Research Foundation.

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