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COVID-19 Antibody Responses In Cystic Fibrosis (CAR-CF)

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ClinicalTrials.gov Identifier: NCT04904445
Recruitment Status : Recruiting
First Posted : May 27, 2021
Last Update Posted : March 9, 2022
Queen's University, Belfast
Cystic Fibrosis Foundation
European Cystic Fibrosis Society - Clinical Trial Network
Information provided by (Responsible Party):
Dr. H.M. Janssens, Erasmus Medical Center

Brief Summary:

Coronavirus disease 2019 (COVID-19) which is caused by the virus SARS-CoV-2 has resulted in an ongoing global pandemic. It is unclear whether the relatively low number of reported cases of COVID-19 in people with CF (pwCF) is due to enhanced infection prevention practices or whether pwCF have protective genetic/immune factors. This study aims to prospectively assess the proportion of pwCF, including both adults and children with CF who have evidence of SARS-CoV-2 antibodies over a two-year period. This study will also examine whether pwCF who have antibodies for SARS-CoV-2 have a different clinical presentation and what impact this has on their CF disease. The proposed study will recruit pwCF from paediatric and adult CF centres throughout the United Kingdom. Serological testing to detect antibodies will be performed on blood samples taken at month 0, 6, 12, 18 and 24 with additional time-points if bloodwork is available via normal clinical care. Clinical data on, lung function, CF-related medical history, pulmonary exacerbations, antibiotic use, and microbiology and vaccination receipt, will be collected during routine clinical assessments.

Associations will be examined between socio-demographic and clinical variables and serologic testing. The effects of SARS-CoV-2 infection on clinical outcomes and analyse end-points will be examined to explore any age-related or gender-based differences, as well as subgroup analysis of outcomes in lung-transplant recipients and pwCF receiving CFTR modulator therapies. As pwCF receive COVID-19 vaccination a comparison of the development and progression of anti-SARS-CoV-2 antibodies in pwCF following natural infection and vaccination SARS-CoV-2 over time will be performed.

Condition or disease
Cystic Fibrosis

Detailed Description:

This is a prospective, longitudinal cohort study in people with Cystic Fibrosis (pwCF) that involves repeated serial sampling of participants. This study design was chosen to provide comprehensive information on SARS-CoV-2 seroprevalence changes over time and the subsequent clinical impact on pwCF. The study will be conducted at participating CF centres over a 3-year period. Study participants will include paediatric and adult pwCF. Participating investigators can enrol all eligible pwCF over a 12-month period. Participants are then followed up for 24 months. Participants will donate blood samples at their routine clinic visits. Blood samples will be collected at Day 0 (baseline), at Months 6, 12, 18 and 24 (to coincide with routine clinical reviews). Additional blood samples will be taken opportunistically every time the participant visits the clinic for blood draws. These blood samples could be related to, routine care, annual review visits, pulmonary exacerbations (PEx), CF complications or when initiating new treatments (e.g. CFTR modulators).

Serum from blood samples will be shipped to a central laboratory (Queen's University Belfast) for standardized measurement of SARS-CoV-2 antibodies.

Alongside the blood samples the investigator will also collect clinical data from the patient's health records and will input this data into the case report form (CRF). Clinical data will be collected in conjunction with routine care visits, according to local clinical practice. Investigators will collect data elements from information routinely recorded in the patients' medical records. Data will be collected at baseline, month 6, 12, 18 and 24 as per the study schedule, and at additional blood sampling timepoints as previously explained above. Data collection will include routine data available from CF clinic follow-ups including background demographic information, CF medical history, medications, exacerbation information, sputum microbiology and clinical and lung function parameters. Information on SARS-CoV-2 infection history and vaccine receipt will also be collected.

The maximum follow-up duration of participation in the study for each patient will be 24 months. This study duration (24-month follow-up) is justified as it provides sufficient time to observe changes in antibody prevalence over the course of the COVID-19 pandemic as well as sufficient time to determine long term clinical outcomes for pwCF who are SARS-CoV-2 seropositive. Furthermore, we anticipate the 2-year study follow-up period will provide sufficient time to observe the impact of vaccination on antibody levels given that a number of vaccines are now commercially available.

The investigators will compare the level of antibody responses between natural COVID-19 infection and vaccination in pwCF and how this varies over time. This will be achieved by analyzing seroprevalence and antibody levels according to natural infection and vaccination status and according to time of sample post infection or post vaccination, if known.

Optional Study sample collection:

For participants who consent, a second blood sample will also be drawn into EDTA tubes (plasma). Consent to this optional study sample would allow this sample and any remaining serum (following antibody testing) to be stored for future analysis and allow further research to be carried out on related studies to COVID-19 and CF.

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Study Type : Observational
Estimated Enrollment : 30 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: COVID-19 Antibody Responses In Cystic Fibrosis
Actual Study Start Date : May 21, 2021
Estimated Primary Completion Date : May 1, 2024
Estimated Study Completion Date : May 1, 2024

Primary Outcome Measures :
  1. To evaluate SARS-CoV-2 seroprevalence [ Time Frame: 3-year period (comprising a 1-year enrollment period and a 2-year follow-up) ]
    proportion of pwCF with at least 1 seropositive result over the study period and the difference in this proportion by age, geographical area and over time.

  2. To examine the associations [ Time Frame: 3-year period (comprising a 1-year enrollment period and a 2-year follow-up) ]
    Association of SARS-CoV-2 seropositivity, clinical symptoms and clinical outcomes in pwCF: incidence of symptomatic COVID-19 over the study period and severity; proportion of seropositive pwCF with subsequent CF exacerbation compared to pwCF who are seronegative; death rate in pwCF with at least one seropositive result compared to pwCF who are seronegative.

  3. To perform a longitudinal comparison [ Time Frame: 3-year period (comprising a 1-year enrollment period and a 2-year follow-up) ]
    Longitudinal comparison of the detection including level and duration of anti-SARS-CoV-2 antibodies in pwCF following natural infection and SARS-CoV-2 vaccination.

Secondary Outcome Measures :
  1. Storage of samples for future analysis [ Time Frame: anticipated 5-10 years ]
    Serum proteomic and genomic responses of pwCF who are SARS-CoV-2 seropositive an seronegative.

Biospecimen Retention:   Samples With DNA

A 6-monthly blood sample will be collected when the participants attend clinic or hospital.

For participants who consent to the optional study, a second blood sample will also be drawn.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Consenting people with cystic fibrosis of any age, genotype, transplant status and disease severity will be eligible to participate in the study. The study population is expected to be representative of the general CF population.

Inclusion Criteria:

  • Consenting people with cystic fibrosis of any age, genotype, transplant status and disease severity.

Exclusion Criteria:

  • Refusal to give informed consent
  • Contraindication to venepuncture.

Participants already enrolled in a clinical trial are eligible for enrollment in this study. Inclusion in CAR-CF should not preclude enrollment in other observational clinical trial studies or clinical trials of an investigational medicinal product (CTIMP).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04904445

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Contact: Hettie M Janssens, Dr +31 (0)10 7036263 h.janssens@erasmusmc.nl
Contact: Edmond HH Rings, Prof.dr. +31 (0)10 7036226 e.rings@erasmusmc.nl

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Erasmus Medical Center Sophia Children's Hospital Recruiting
Rotterdam, South-Holland, Netherlands, 3015 GD
Contact: Hettie Janssens, MD, PhD    +31 10 703 6263    h.janssens@erasmusmc.nl   
Contact: Badies Manaï, MSc    +31 10 706 6683    b.manai@erasmusmc.nl   
Sponsors and Collaborators
Erasmus Medical Center
Queen's University, Belfast
Cystic Fibrosis Foundation
European Cystic Fibrosis Society - Clinical Trial Network
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Study Director: Damian Downey, Dr Queen's University, Belfast
Additional Information:

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Responsible Party: Dr. H.M. Janssens, Pediatric Pulmonologist, Erasmus Medical Center
ClinicalTrials.gov Identifier: NCT04904445    
Other Study ID Numbers: NL
First Posted: May 27, 2021    Key Record Dates
Last Update Posted: March 9, 2022
Last Verified: February 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Dr. H.M. Janssens, Erasmus Medical Center:
Cystic Fibrosis
Additional relevant MeSH terms:
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Cystic Fibrosis
Respiratory Tract Infections
Pneumonia, Viral
Virus Diseases
Coronavirus Infections
Coronaviridae Infections
Nidovirales Infections
RNA Virus Infections
Lung Diseases
Respiratory Tract Diseases
Pathologic Processes
Pancreatic Diseases
Digestive System Diseases
Genetic Diseases, Inborn
Infant, Newborn, Diseases