Results
We contacted 120 patients aged 1-30 years by telephone from March 05 to May 15, 2020. Before and after the quarantine period, the Mean (StDev) time between the two onsite visits in the clinic was 4.08 (1.53) months, so we decided to have at least two telephone visits during the quarantine period. The baseline characteristics of the study population are shown in Table 1.
The mean FEV1% increased significantly over the quarantine period (mean, 95% Confidence Interval ΔFEV1 (3.19; 0.36- 6.02), p= 0.028; while the mean weight increased significantly; mean, 95% Confidence Interval ΔWeight, kg (1.0; 0.61-1.4); p<0.0001. These changes were significantly greater among the younger age groups (R2= 0.3030; p=0.014).
Several CF complications were reported over the lockdown period, Table 2. Thirty-eight out of 120 patients (28.33%) were identified to have a pulmonary exacerbation over the quarantine period, which was treated either with oral antibiotics (89.5%) or with hospitalization and use of IV antibiotics (3%). Moreover, two patients were diagnosed and hospitalized because of DIOS; one was complicated with pneumothorax, two reported significant weight loss due to new onset of pancreatic insufficiency, confirmed by abnormal faecal elastase, one patient complicated with haemoptysis, and one patient with new onset of CFRD.
Before the lockdown,79.5% of the patients reported performing physiotherapy daily, 8.2% reported performing physiotherapy 2-4 times per week, and 12.3% reported performing no physiotherapy at all. Most of the CF patients did not change the frequency of their daily physiotherapy practice during the COVID19 pandemic (Table 3). Moreover, before the pandemic, 49.2% of the CF patients performed extra assisted airway clearance; a physiotherapist visited their home once a week through a home care program. During the COVID19 pandemic period, only 27.1% of them continued this program.
Concerning physical exercise, before the COVID-19 pandemic, 97 (81%) of the CF patients were reported performing regular exercise weekly; 21.6% of them followed a combined aerobic and anaerobic exercise in a gym, 16.6% participated in outskirt team sports, like basketball or football (Table 4). During the pandemic, most patients changed the type (72% of the patients) and the frequency of exercise, with 71% of the patients performing less exercise than before.