Introduction: The coronavirus 2019 (COVID-19) pandemic has demanded care changes for patients with chronic disease. Patients with 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 ten 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 FEV1 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.

Background: The role of Cardiopulmonary Exercise Testing (CPET) in the assessment of prognosis in CF is crucial. However, as the overall survival of the disease becomes better, the need for examinations that can predict pulmonary exacerbations (PEx) and subsequent deterioration becomes evident. Aim: To evaluate whether CPET derived parameters can be used as prognostic indexes for pulmonary exacerbations in patients with CF. Methods: Data from a 10-year follow up with CPET and spirometry of CF patients were used to perform our analyses. Pulmonary exacerbations were recorded. We used a survival analysis through Cox Regression to assess the prognostic role of CPET parameters for PeX. CPET parameters and other variables such as sputum culture, age, and spirometry measurements were tested via multivariate cox models. Results: During a 10-year period (2009-2019) 78 CF patients underwent CPET. Cox regression analysis revealed that VO2peak% predicted (Hazard ratio (HR), 0.988 (0.975, 1.000) p=0.042), PetCO2 ( End-tidal CO2 at peak exercise) (HR 0.948 (0.913, 0.984) p=0.005), VE/VO2, (respiratory equivalent for oxygen at peak exercise) (HR 1.032 (1.003, 1.062) p=0.033 were significant predictors of pulmonary exacerbations in the short term after the CPET. Additionally, patients with VO2peak% predicted <60% had 4,5 times higher relative risk of having a PEx than those with higher exercise capacity. Conclusions: CPET can provide valuable information regarding upcoming pulmonary exacerbation in CF. Patients with VO2peak <60% are at great risk of subsequent deterioration. Regular follow up of CF patients with Exercise Testing can highlight their clinical image and direct therapeutic interventions.