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COVID-19 ANtibody Responses in Cystic Fibrosis: CAR-CF (CAR-CF)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT05745948
Recruitment Status : Recruiting
First Posted : February 27, 2023
Last Update Posted : February 27, 2023
Queen's University, Belfast
European Cystic Fibrosis Society - Clinical Trial Network
Cystic Fibrosis Foundation
Hospital Vall d'Hebron
Information provided by (Responsible Party):
Hospital Universitari Vall d'Hebron Research Institute

Brief Summary:

The 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 has 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 in Europe. 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 sociodemographic and clinical variables and serologic testing. The effects of SARS-CoV-2 infection on clinical outcomes and analyze end-points will be examined to explore any age-related or gender-based differences, as well as a 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
COVID-19 Cystic Fibrosis

Detailed Description:

This is a prospective, longitudinal cohort study in people with Cystic Fibrosis (pwCF) that involves the 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 centers over a 3-year period. Study participants will include pediatric and adult pwCF. For the UK section of the study, UK investigators in the European Cystic Fibrosis Society-Clinical Trials Network (ECFS-CTN) will be invited to participate. Participating investigators can enroll 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 investigators 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 patient's medical records. Data will be collected at baseline, months 6, 12, 18, and 24 as per the study schedule, and at additional blood sampling time points 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 : 150 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: COVID-19 Antibody Responses in Cystic Fibrosis: CAR-CF
Actual Study Start Date : January 24, 2023
Estimated Primary Completion Date : May 2025
Estimated Study Completion Date : May 2025

Primary Outcome Measures :
  1. 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. Association of SARS-CoV-2 seropositivity, clinical symptoms and clinical outcomes in pwCF [ Time Frame: 3-year period (comprising a 1-year enrollment period and a 2-year follow-up) ]
    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. Longitudinal comparison of the detection of anti-SARS-CoV-2 antibodies in pwCF following natural infection and SARS-CoV-2 vaccination [ Time Frame: 3-year period (comprising a 1-year enrollment period and a 2-year follow-up) ]
    Measuring detectable antibody levels for each study participant at baseline and at each study time point including 6,12, 18 and 24 months post enrollment with additional samples if participant has blood drawn for other clinical care reason

Secondary Outcome Measures :
  1. Serum proteomic and genomic responses of pwCF who are SARS-CoV-2 seropositive and seronegative. [ Time Frame: anticipated 5-10 years ]
    Measuring detectable proteomic and genomic responses in pwCF according to serostatus (positive or negative for antibodies) as well as according to natural infection versus vaccination

Biospecimen Retention:   Samples With DNA
Samples With DNA Blood serum samples will be collected for analysis of COVID-19 antibody levels. For participants who consent to the optional study, a second blood sample will also be drawn into EDTA tubes (plasma)

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:

  • 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

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 identifier (NCT number): NCT05745948

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Contact: Silvia Gartner, MD +34934893197
Contact: Antonio Alvarez, PhD +34934893197

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Hospital Universitari Vall d'Hebron. Cystic Fibrosis Unit Recruiting
Barcelona, Spain, 08035
Contact: Silvia Gartner, MD    +34934893197   
Contact: Antonio Alvarez, PhD    +34934893197   
Sub-Investigator: Sandra Rovira, PhD         
Sub-Investigator: Sonia Lopez, coordinator         
Sponsors and Collaborators
Hospital Universitari Vall d'Hebron Research Institute
Queen's University, Belfast
European Cystic Fibrosis Society - Clinical Trial Network
Cystic Fibrosis Foundation
Hospital Vall d'Hebron
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Principal Investigator: Silvia Gartner, MD Hospital Vall d'Hebron
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Responsible Party: Hospital Universitari Vall d'Hebron Research Institute Identifier: NCT05745948    
Other Study ID Numbers: PR(AMI)381/2021
First Posted: February 27, 2023    Key Record Dates
Last Update Posted: February 27, 2023
Last Verified: February 2023
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
Additional relevant MeSH terms:
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Cystic Fibrosis
Pneumonia, Viral
Respiratory Tract Infections
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