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Dinamics and impact of respiratory infections due to SARS-CoV-2 and other respiratory viruses in individuals with cystic fibrosis


Patients with cystic fibrosis (CF) have suppurative and recurrent pulmonary manifestations. Some respiratory viruses may have a greater impact on these patients, and previous studies have indicated a significant role for rhinovirus C and also for coronavirus subtypes, such as NL-63. Hypothesis: Pediatric CF individuals will have low clinical manifestations of SARS-CoV-2 infection, when compared to adult CF individuals. A different immune response is expected among children and adults with CF during SARS-CoV-2 infection, including cytokine expression profile and markers such as CD-26 (dipepty peptidase 4) in peripheral blood. Methods: Approximately 150 patients (75 adults and 75 pediatric) will be approached during routine consultations and during acute respiratory exacerbation to collect samples of respiratory secretion, blood sample and perform usual clinical consultation / pulmonary function markers and pulse oximetry, according to the outpatient clinic routine (ICr-HCFMUSP and INCOR-HCFMUSP). Molecular point-of-care tests (commercial panels) will be used for identification of respiratory viruses and SARS-CoV-2. Samples with picornavirus detection will be subjected to real-time PCR specific for rhinovirus and enterovirus D68, and sequencing of the positive samples for rhinovirus will be done to determine the species. The peripheral blood samples will be used to evaluate the immune response, profile of circulating cells and cytokines, presence of antibodies to SARS-CoV-2 and P. aeruginosa, and also presence of antibodies to other species of coronavirus by plaque reduction neutralizing tests (PRNT). Samples with identification of SARS-CoV-2 will be subjected to genome sequencing for epidemiological purposes. The main clinical outcomes assessed will be acute pulmonary exacerbation, hospital admission, acute (or acute) respiratory failure, appearance of new bacterial pathogens. (AU)

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