Change in CF care during COVID-19 pandemic: Single-center experience in a middle-income setting
Elpis Hatziagorou1, Ilektra Toulia1, Vasiliki Avramidou1
1Paediatric Pulmonology and Cystic Fibrosis Unit, 3rd Paediatric Department, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Insights
During COVID-19, telephone monitoring improved cystic fibrosis (CF) patient care. Despite lockdowns, key health metrics like lung function and weight improved, showing the effectiveness of remote strategies for chronic disease management.
Area of Science:
- Pulmonology
- Infectious Diseases
- Telemedicine
Background:
- The COVID-19 pandemic necessitated changes in chronic disease care, particularly for cystic fibrosis (CF) patients at higher risk of severe SARS-CoV-2 infection.
- Safer care delivery models were essential to mitigate transmission risks.
Discussion:
- This study assessed the impact of lockdown and remote monitoring on CF patients in a middle-income setting.
- Telephone visits replaced in-person clinic visits for monitoring health and therapy adherence over 10 weeks.
- Pulmonary exacerbations affected 28.33% of patients, with most managed with oral antibiotics.
Key Insights:
- Despite quarantine, mean forced expiratory volume in 1-second and body weight significantly increased post-lockdown.
- Most patients maintained physiotherapy frequency, while 71% adapted their exercise routines.
- Telephone monitoring proved crucial for maintaining CF patient care during the pandemic.
Outlook:
- Implementing telephone contact is vital for CF patient care during pandemics.
- Further research is needed to compare outcomes between traditional and telemedicine clinics for CF patients.
Introduction:
The coronavirus 2019 (COVID-19) pandemic has demanded care changes for patients with chronic disease. Patients with cystic fibrosis (CF) are considered at higher risk of developing severe manifestations in the case of SARS-CoV-2 infection, and a need for new ways of safer care delivery has been required to avoid transmission.
Objectives:
To assess the impact of the lockdown during the first wave of the COVID-19 pandemic and remote monitoring on patient's health status and daily maintenance therapy in a middle-income resource setting.
Methods:
During the first wave of the pandemic period, we changed from regular clinic visits to telephone visit calls to monitor our patients' health condition and adherence to physiotherapy and physical exercise.
Results:
A total of 120 patients or their caregivers have been contacted by telephone call visits over 10 weeks. During this period, 38 patients (28.33%) were identified to have pulmonary exacerbation; 89.5% were prescribed oral antibiotics, 3% were hospitalized to get iv antibiotics, and 8% of the patients presented other CF complications. Most of the patients did not change the frequency of the daily physiotherapy. Moreover, 71% of the patients who performed regular physical exercise changed the frequency and the type of exercise during the quarantine period. Interestingly, mean forced expiratory volume in 1 s and body weight increased significantly and after the lockdown period.
Conclusions:
During the COVID-19 pandemic, the implementation of telephone contact processes aiming for CF patients' appropriate care is of great importance. Further studies are needed to evaluate patient outcomes when transitioning from face-to-face clinics to telemedicine clinics.
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