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\begin{document}

\title{SARS-CoV-2 infection in children with Cystic Fibrosis: A Cross-sectional
Multicenter Study in Spain. New waves, new knowledge.}



\author[1]{Pedro Mondejar-López}%
\author[2]{Laura Moreno-Galarraga}%
\author[3]{Cristina De Manuel}%
\author[4]{Enrique Blitz Castro}%
\author[5]{Maynor Bravo-Lopez}%
\author[5]{Silvia Gartner}%
\author[6]{Estela  Pérez-Ruiz}%
\author[6]{Pilar Caro-Aguilera}%
\author[7]{Veronica Sanz Santiago }%
\author[7]{Alejandro López-Neyra}%
\author[8]{Maria Luna-Paredes}%
\author[9]{Miguel Garcia Gonzalez}%
\author[10]{Jordi Costa}%
\author[10]{Maria Cols-Roig}%
\author[11]{Isabel Delgado-Pecellín}%
\author[12]{Silvia Castillo-Corullón}%
\author[3]{Marta Ruiz de Valbuena}%
\author[1]{Patricia W. García-Marcos}%
\author[13]{Antonio Aguilar Fernandez}%
\author[14]{Carlos Martín}%
\author[15]{Mª Verisima Barajas Sanchez}%
\author[16]{Orlando Mesa Medina}%
\author[17]{Cati Bover-Bauza}%
\author[17]{Joan Figuerola Mulet}%
\author[18]{Belén García Avilés}%
\author[19]{Mª Jesus Rodriguez Saez}%
\author[20]{Carlos Garcia-Magan}%
\author[21]{Patricia Juarez Marruecos}%
\author[22]{Jose Ramon Gutierrez-Martinez}%
\author[23]{Isidoro Cortell-Aznar}%
\author[24]{David Gomez-Pastrana}%
\author[25]{M. Valle Velasco Gonzalez}%
\author[3]{M. Isabel Barrio}%
\author[1]{Manuel Sanchez-Solis}%
\author[9]{Óscar Asensio de la Cruz}%
\author[26]{Maria Dolores Pastor-Vivero}%
\affil[1]{Hospital Clinico Universitario Virgen de la Arrixaca}%
\affil[2]{Instituto de Investigacion Sanitaria de Navarra}%
\affil[3]{Fundacion para la Investigacion e Innovacion Biomedica de Atencion Primaria de la Comunidad de Madrid}%
\affil[4]{Instituto Ramon y Cajal de Investigacion Sanitaria}%
\affil[5]{Hospital Universitari Vall d'Hebron Servei de Medicina Interna}%
\affil[6]{Hospital Regional Universitario de Malaga}%
\affil[7]{Hospital Infantil Universitario Nino Jesus}%
\affil[8]{Hospital Universitario 12 de Octubre}%
\affil[9]{Consorcio Corporacion Sanitaria Parc Tauli}%
\affil[10]{Hospital Sant Joan de Deu}%
\affil[11]{Centro de Investigacion Biomedica en Red Enfermedades Respiratorias}%
\affil[12]{Hospital Clinico Universitario}%
\affil[13]{Hospital Universitario Materno Infantil de Canarias}%
\affil[14]{Hospital Universitario Miguel Servet}%
\affil[15]{Hospital Clinico de Salamanca}%
\affil[16]{Hospital Universitario Nuestra Senora de la Candelaria}%
\affil[17]{Hospital Universitari Son Espases Servei de Cirurgia Pediatrica}%
\affil[18]{Hospital Universitari Sant Joan d'Alacant}%
\affil[19]{Hospital Alvaro Cunqueiro}%
\affil[20]{Hospital Clinico Universitario de Santiago de Compostela Servicio de Cardiologia}%
\affil[21]{Complejo Hospitalario Torrecardenas}%
\affil[22]{Hospital Universitario Central de Asturias}%
\affil[23]{Hospital Universitari i Politecnic La Fe Biblioteca}%
\affil[24]{Hospital Universitario de Jerez de la Frontera}%
\affil[25]{Hospital Universitario de Canarias}%
\affil[26]{Instituto de Investigacion Sanitaria Biocruces Bizkaia}%


\vspace{-1em}



  
  \date{May 18, 2024}


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\selectlanguage{english}
\begin{abstract}
\textbf{Introduction} Viral infections are associated with pulmonary
exacerbations in children with Cystic Fibrosis (cwCF), but after 3 years
of SARS-CoV-2 pandemic, whether cwCF are at higher risk of developing
COVID-19 or its adverse consequences remains controversial.
\textbf{Methods} We conducted an observational, multicenter,
cross-sectional study of cwCF infected by SARS-CoV-2 between March 2020
and June 2022, (1 \textsuperscript{st} to 6 \textsuperscript{th}
COVID-19 pandemic waves) in Spain. The study aimed to describe patients'
basal characteristics, SARS-CoV-2 clinical manifestations and outcomes,
and whether there were differences across the pandemic waves.
\textbf{Results} During study time, 351 SARS-CoV2 infections were
reported among 341 cwCF. Median age was 8.5 years (range 0-17) and 51\%
were female. Cases were unevenly distributed across the pandemic, with
most cases (82\%) clustered between November 2021 and June 2022 (6
\textsuperscript{th} wave, also known as Omicron Wave due to the higher
prevalence of this strain in that period in Spain). Most cwCF were
asymptomatic (24.8\%) or presented with mild Covid-19 symptoms (72.9\%).
Among symptomatic, most prevalent symptoms were fever (62\%) and
increased cough (53\%). No multisystem inflammatory syndrome (MIS-C),
persisting symptoms, long-term sequelae or deaths were reported.
\textbf{Conclusions} Spanish current data indicate that cwCF do not
experience higher risks of SARS-CoV-2 infection nor worse health
outcomes or sequelae. Changes in patients' basal characteristics,
clinical courses and outcomes were detected across waves. While the
pandemic continues, and new SARS-CoV-2 variants are being identified, a
worldwide monitoring of COVID-19 in pediatric CF patients is needed.%
\end{abstract}%



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