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COVID-19: Recommendations from GBEFC professionals

These recommendations were issued on March 13, 2020, and may be modified as the Brazilian Ministry of Health or medical societies provide new guidance.

Apparently, having cystic fibrosis (CF) does not increase the chances of being infected with the new coronavirus (known as SARS-CoV-2).
However, there is currently no information on how SARS-CoV-2 infection (known as COVID-19) will affect people with cystic fibrosis. Those who are well may experience a mild illness, but those with significant respiratory problems are likely to be at risk for more severe manifestations if they become infected with the virus.

The current GBEFC recommendations are the following:

1. Follow guidance from the Brazilian Ministry of Health and medical societies to try to prevent the infection and spread of SARS-CoV-2:

  • Wash your hands regularly, especially after being in public places. Avoid touching any surface that is touched regularly, such as doorknobs and handrails, and avoid touching your face as much as possible. Use hand sanitizer often if available;
  • Avoid close contact with anyone with respiratory symptoms;
  • Avoid places where the risk of exposure is potentially greater, such as crowds, especially in poorly ventilated areas;
  • Check whether you are up to date with your vaccinations against other preventable infections, including influenza;
  • Avoid international travel, nonessential air travel, and cruise travel.

2. Take care of your health by maintaining your usual treatments:

  • Attend your scheduled appointments unless advised otherwise by your CF team;
  • Check whether you are up to date with your medication prescriptions and whether you have been guided by your CF team on how to proceed if respiratory symptoms become more severe or signs of a new infection appear (associated or not with SARS-CoV-2);
  • Wear a surgical or cloth mask when attending outpatient visits, which will help protect others from becoming infected if you already have COVID-19 or typical CF bacteria and are coughing and sneezing;
  • There are currently no general recommendations on school attendance. This will depend on local circumstances and individual counseling from your CF team;
  • Regarding work, we recommend contacting your employer to consider adjustments to your workplace to help protect you. Your CF team can provide counseling and support for this.

3. Clinical signs of SARS-CoV-2 infection and what to do:

  • These are classical clinical signs of respiratory virus infection: fever, cough, sore throat, nasal congestion, headache, malaise, and body aches;
  • People with these symptoms should avoid contact with others and cover their mouth when coughing or sneezing using handkerchiefs, which should be discarded immediately. If you use your hands, these should be sanitized immediately;
  • In CF, there may be more specific symptoms, such as increased secretion (sputum), changes in the color/appearance of sputum, worsening shortness of breath, etc. These should be communicated to the FC team for guidance on how to proceed;
  • Seeking care at an emergency department (or your CF center) is recommended if more severe symptoms arise, such as shortness of breath, blood in sputum, persistent vomiting or inability to feed, prostration, and purplish lips or extremities.

Note #1: If you still have specific medical questions, please contact the CF team with access to your health history.

Note #2: People with CF who have had a lung or liver transplant may need extra precautions and should speak with their transplant team.