tetano
Editor, Senior Moderator
Mult Scler Relat Disord
. 2023 Nov 10:81:105120.
doi: 10.1016/j.msard.2023.105120. Online ahead of print. The impact of COVID-19 on a Southern Chinese cohort with neuromyelitis optica spectrum disorders
Jian Zhong[SUP] 1 [/SUP], Yu Wu[SUP] 2 [/SUP], Shaodan Zhou[SUP] 1 [/SUP], Chao Liu[SUP] 1 [/SUP], Yishuang Wen[SUP] 1 [/SUP], Manli Liang[SUP] 1 [/SUP], Taiyan Li[SUP] 1 [/SUP], Ting Lu[SUP] 1 [/SUP], Sirao Lv[SUP] 1 [/SUP], Zhuowei Gong[SUP] 1 [/SUP], Dayuan Lao[SUP] 1 [/SUP], Xiaoli Cao[SUP] 1 [/SUP], Yulan Tang[SUP] 1 [/SUP], Wen Huang[SUP] 3 [/SUP]
Affiliations
Background: There are few studies on risk factors for coronavirus disease 2019 (COVID-19) infection in patients with Neuromyelitis Optica Spectrum Disorders (NMOSD). The relationship between NMOSD relapse and COVID-19 needs to be evaluated. The objective of our study is to identify the risk factors of COVID-19 infection and NMOSD relapse among NMOSD patients with COVID-19.
Method: A total of 379 NMOSD patients registered in a NMOSD database were included in this case-control study after the end of the COVID-19 quarantine and restriction policies on December 6, 2022 in China. Data were obtained from the database. Additional information was obtained by questionnaires and the Neurology out-patient clinic. The clinical characteristics of NMOSD patients with COVID-19 were described. Risk factors associated with COVID-19 infection and outcome among patients with NMOSD were analyzed. Risk factors associated with relapse in NMOSD patients with COVID-19 were also identified.
Results: 239 (63.1%) NMOSD patients were infected with COVID-19. Patients with NMOSD who were infected with COVID-19, in comparison to those without COVID-19, were younger at the time of interview (median [IQR] age: 43.00 [32.00-55.00] vs 49.50 [35.25-56.00] years, P = 0.029), younger at NMOSD onset (median [IQR] age: 38.00 [27.00-51.00] vs 45.00 [32.00-52.75] years, P = 0.013), had abnormal visual evoked potentials before infection (73.4% vs 54.3% P = 0.029), had lower baseline Activities of Daily Living Scale (ADL) scores (median [IQR] ADL: 14.00 [14.00-16.00] vs 14.00 [14.00-19.00], P = 0.014) or lower baseline modified Rankin Scale (mRS) scores (1.12±0.749 vs 1.33±0.991, P = 0.037), and were less frequently treated with more than 10 mg prednisone or 8 mg methylprednisolone (25.0% vs 36.0%,p = 0.026). All 9 NMOSD patients who had symptomatic cerebral syndrome developed moderate/severe COVID-19. A higher percentage of patients with moderate/severe COVID-19 experienced more than one core clinical NMOSD symptoms (61.5% vs 55.1%, p = 0.044), compared to patients with mild COVID-19. Higher risk of NMOSD relapse among NMOSD patients with COVID-19 was associated with higher Expanded Disability Status Scale (EDSS) scores (median[IQR] EDSS: 2.00 [1.00-3.00] vs 1.50 [1.00-2.25], P = 0.037) and drug treatments disruption (21.6% vs 5.0% P<0.001).
Conclusions: NMOSD patients with younger age, lower baseline ADL or mRS had higher incidence of being diagnosed with COVID-19 during pandemic. Glucocorticoid use may decrease the risk of COVID-19. NMOSD patients with symptomatic cerebral syndrome before the COVID-19 pandemic are associated with worse COVID-19 outcomes. Drug treatment disruption may result in relapse among NMOSD patients with COVID-19.
Keywords: COVID-19; Neuromyelitis optica spectrum disorders; Relapse; SARS-CoV-2.
. 2023 Nov 10:81:105120.
doi: 10.1016/j.msard.2023.105120. Online ahead of print. The impact of COVID-19 on a Southern Chinese cohort with neuromyelitis optica spectrum disorders
Jian Zhong[SUP] 1 [/SUP], Yu Wu[SUP] 2 [/SUP], Shaodan Zhou[SUP] 1 [/SUP], Chao Liu[SUP] 1 [/SUP], Yishuang Wen[SUP] 1 [/SUP], Manli Liang[SUP] 1 [/SUP], Taiyan Li[SUP] 1 [/SUP], Ting Lu[SUP] 1 [/SUP], Sirao Lv[SUP] 1 [/SUP], Zhuowei Gong[SUP] 1 [/SUP], Dayuan Lao[SUP] 1 [/SUP], Xiaoli Cao[SUP] 1 [/SUP], Yulan Tang[SUP] 1 [/SUP], Wen Huang[SUP] 3 [/SUP]
Affiliations
- PMID: 37979411
- DOI: 10.1016/j.msard.2023.105120
Background: There are few studies on risk factors for coronavirus disease 2019 (COVID-19) infection in patients with Neuromyelitis Optica Spectrum Disorders (NMOSD). The relationship between NMOSD relapse and COVID-19 needs to be evaluated. The objective of our study is to identify the risk factors of COVID-19 infection and NMOSD relapse among NMOSD patients with COVID-19.
Method: A total of 379 NMOSD patients registered in a NMOSD database were included in this case-control study after the end of the COVID-19 quarantine and restriction policies on December 6, 2022 in China. Data were obtained from the database. Additional information was obtained by questionnaires and the Neurology out-patient clinic. The clinical characteristics of NMOSD patients with COVID-19 were described. Risk factors associated with COVID-19 infection and outcome among patients with NMOSD were analyzed. Risk factors associated with relapse in NMOSD patients with COVID-19 were also identified.
Results: 239 (63.1%) NMOSD patients were infected with COVID-19. Patients with NMOSD who were infected with COVID-19, in comparison to those without COVID-19, were younger at the time of interview (median [IQR] age: 43.00 [32.00-55.00] vs 49.50 [35.25-56.00] years, P = 0.029), younger at NMOSD onset (median [IQR] age: 38.00 [27.00-51.00] vs 45.00 [32.00-52.75] years, P = 0.013), had abnormal visual evoked potentials before infection (73.4% vs 54.3% P = 0.029), had lower baseline Activities of Daily Living Scale (ADL) scores (median [IQR] ADL: 14.00 [14.00-16.00] vs 14.00 [14.00-19.00], P = 0.014) or lower baseline modified Rankin Scale (mRS) scores (1.12±0.749 vs 1.33±0.991, P = 0.037), and were less frequently treated with more than 10 mg prednisone or 8 mg methylprednisolone (25.0% vs 36.0%,p = 0.026). All 9 NMOSD patients who had symptomatic cerebral syndrome developed moderate/severe COVID-19. A higher percentage of patients with moderate/severe COVID-19 experienced more than one core clinical NMOSD symptoms (61.5% vs 55.1%, p = 0.044), compared to patients with mild COVID-19. Higher risk of NMOSD relapse among NMOSD patients with COVID-19 was associated with higher Expanded Disability Status Scale (EDSS) scores (median[IQR] EDSS: 2.00 [1.00-3.00] vs 1.50 [1.00-2.25], P = 0.037) and drug treatments disruption (21.6% vs 5.0% P<0.001).
Conclusions: NMOSD patients with younger age, lower baseline ADL or mRS had higher incidence of being diagnosed with COVID-19 during pandemic. Glucocorticoid use may decrease the risk of COVID-19. NMOSD patients with symptomatic cerebral syndrome before the COVID-19 pandemic are associated with worse COVID-19 outcomes. Drug treatment disruption may result in relapse among NMOSD patients with COVID-19.
Keywords: COVID-19; Neuromyelitis optica spectrum disorders; Relapse; SARS-CoV-2.