Data_Sheet_2_Impact of the COVID-19 pandemic and associated lockdown measures on the management, health, and behavior of the cystic fibrosis population in France during 2020 (MUCONFIN).PDF

BackgroundMost of the studies on cystic fibrosis (CF) focused on SARS-CoV-2 prevalence and suggested a low incidence of infection in this population. We aimed to assess the impact of the pandemic and related lockdown measures implemented in May 2020 in response to the first wave of SARS-CoV-2 infection on healthcare access, health, and behavior in CF patients.
MethodsA national questionnaire opened online from May 15th, 2020 to June 11th, 2020 was completed by 751 CF-patients, aged 14 years and over. It comprised questions about access to healthcare, anxiety and depression, smoking, alcohol, drug and psychotropic drug consumption, adherence to CF treatment, and constraints. A semi-structured comprehensive interview was performed no later than 1 month after the end of the lockdown in 16 CF-patients.
ResultsThe mean age of the population was 28.0 [interquartile range (IQR) 20.0–37.0] years old. More than 75% of in-person consultations scheduled during the lockdown were canceled. Alternatively, 27% were postponed, and telehealth consultations were proposed and accepted in almost 40% of cases. More than 75% of the scheduled physiotherapy sessions were canceled and replaced mainly by self-drainage. Annual follow-up clinic visits were consistently postponed whereas required hospitalizations at CF centers for exacerbation were maintained in most cases. While 43.2% CF-patients had signs of anxiety, 51.0% presented symptoms of depression, both associated with increased use of psychotic medications and inversely correlated to COVID-19 prevalence. Among the lower and lower middle classes, very little medical information was obtained or requested by the patient, participation to sports or other activities was low, while excessive home confinement and isolation were more frequent. In contrast, in the upper middle and upper classes, individuals solicitated help to their CF centre, had more physical activities, and maintained contact with friends or families.
ConclusionThe first lockdown in France had only minimal impact on the management care of CF-patients but was associated with increased symptoms of anxiety and depression, together with behavioral changes that varied with social class.
Trial registrationNCT04463628.

研究背景：既往针对囊性纤维化（cystic fibrosis, CF）的研究多聚焦于新型冠状病毒（SARS-CoV-2）感染率，且提示该群体感染发生率较低。本研究旨在评估2020年5月为应对首波SARS-CoV-2感染疫情而实施的封锁措施，对囊性纤维化患者的医疗可及性、健康状况及行为模式的影响。

研究方法：2020年5月15日至6月11日上线的全国性线上问卷，共回收751份14岁及以上囊性纤维化患者的有效答卷。问卷涵盖医疗可及性、焦虑与抑郁状态、吸烟、饮酒、药物及精神药物使用情况、囊性纤维化治疗依从性及相关约束因素。另有16名囊性纤维化患者在封锁措施结束后1个月内接受了半结构化综合访谈。

研究结果：该研究人群的平均年龄为28.0岁[四分位距（interquartile range, IQR）20.0~37.0岁]。封锁期间原定的75%以上的线下门诊被取消，另有27%的门诊被延后，近40%的病例采用远程医疗会诊并获患者接受。超过75%的原定物理治疗疗程被取消，主要以自主排痰替代。年度随访门诊均被延后，而因囊性纤维化急性加重需在专科中心住院的病例则多数得以维持。43.2%的囊性纤维化患者出现焦虑症状，51.0%存在抑郁症状，上述症状均与精神药物使用量增加相关，且与COVID-19感染率呈负相关。在低收入及中低收入群体中，患者获取或主动寻求的医疗信息极少，参与体育或其他活动的比例较低，而过度居家隔离与独处的情况更为普遍。与之相反，中高收入及高收入群体更倾向于向囊性纤维化专科中心寻求帮助，参与更多体育活动，并维持与亲友的联系。

研究结论：法国首轮疫情封锁措施对囊性纤维化患者的诊疗管理仅产生了轻微影响，但却伴随焦虑与抑郁症状的加重，同时出现了随社会阶层差异而变化的行为模式改变。

试验注册：NCT04463628。