tetano
Editor, Senior Moderator
Pediatr Neurol
. 2022 Jun 10;134:7-10.
doi: 10.1016/j.pediatrneurol.2022.06.004. Online ahead of print.
The Outcome of COVID-19 in Pediatric-Onset Multiple Sclerosis Patients
Ibrahim Oncel[SUP] 1 [/SUP], Nurettin Alici[SUP] 2 [/SUP], Ismail Solmaz[SUP] 2 [/SUP], Dogan Dinc Oge[SUP] 3 [/SUP], Yasemin Ozsurekci[SUP] 4 [/SUP], Banu Anlar[SUP] 2 [/SUP]
Affiliations
Abstract
Background: The pathogenesis of multiple sclerosis (MS) involves immune-mediated mechanisms, and disease-modifying therapies (DMTs) administered in MS have immunomodulatory effects. The concern about MS patients' susceptibility to coronavirus disease 2019 (COVID-19) has prompted several studies based on clinical observations and questionnaires. Information about COVID-19 in pediatric-onset multiple sclerosis (POMS) is scarce. The objective of this study was to collect information on the experience of POMS patients with COVID-19 during the pandemic.
Methods: This cross-sectional study was conducted with POMS patients diagnosed at Hacettepe University Pediatric Neurology Department and under 23 years of age between October 1 and December 31, 2021. Those who experienced COVID-19 or had a history of contact and were found seropositive for COVID-19 were evaluated for the severity of COVID-19, disability, treatment status, and comorbidities.
Results: Among the 101 POMS patients, 13 reported having had COVID-19 and five were exposed and seropositive but clinically asymptomatic. Of these 18 patients, 14 were ≤18 years of age at the time of the study. All 13 patients (72%) reported mild symptoms without hospitalization or respiratory support. Four of 18 had a neurological disability (Expanded Disability Status Scale [EDSS] scores ranging between 1 and 7.5), while the remaining had a score of 0. The outcome of COVID-19 was not affected by DMTs, neurological disabilities, and comorbidities.
Conclusions: In this single-center POMS series, the small subgroup of patients who had contacted the SARS-CoV-2 virus or developed COVID-19 had reported no or mild symptoms. This may be partly related to the infrequent use of rituximab in this group. Our results corroborate those in adult-onset MS where no increased risk is reported for patients whose EDSS scores are <6 and who are not on B cell-depleting DMTs. Although less frequently than in adult MS, immunosuppressive DMTs may be needed in POMS; therefore, the importance of appropriate vaccination is to be underlined.
Keywords: COVID-19; Disease-modifying therapy; Pediatric-onset multiple sclerosis; Severity.
. 2022 Jun 10;134:7-10.
doi: 10.1016/j.pediatrneurol.2022.06.004. Online ahead of print.
The Outcome of COVID-19 in Pediatric-Onset Multiple Sclerosis Patients
Ibrahim Oncel[SUP] 1 [/SUP], Nurettin Alici[SUP] 2 [/SUP], Ismail Solmaz[SUP] 2 [/SUP], Dogan Dinc Oge[SUP] 3 [/SUP], Yasemin Ozsurekci[SUP] 4 [/SUP], Banu Anlar[SUP] 2 [/SUP]
Affiliations
- PMID: 35772229
- DOI: 10.1016/j.pediatrneurol.2022.06.004
Abstract
Background: The pathogenesis of multiple sclerosis (MS) involves immune-mediated mechanisms, and disease-modifying therapies (DMTs) administered in MS have immunomodulatory effects. The concern about MS patients' susceptibility to coronavirus disease 2019 (COVID-19) has prompted several studies based on clinical observations and questionnaires. Information about COVID-19 in pediatric-onset multiple sclerosis (POMS) is scarce. The objective of this study was to collect information on the experience of POMS patients with COVID-19 during the pandemic.
Methods: This cross-sectional study was conducted with POMS patients diagnosed at Hacettepe University Pediatric Neurology Department and under 23 years of age between October 1 and December 31, 2021. Those who experienced COVID-19 or had a history of contact and were found seropositive for COVID-19 were evaluated for the severity of COVID-19, disability, treatment status, and comorbidities.
Results: Among the 101 POMS patients, 13 reported having had COVID-19 and five were exposed and seropositive but clinically asymptomatic. Of these 18 patients, 14 were ≤18 years of age at the time of the study. All 13 patients (72%) reported mild symptoms without hospitalization or respiratory support. Four of 18 had a neurological disability (Expanded Disability Status Scale [EDSS] scores ranging between 1 and 7.5), while the remaining had a score of 0. The outcome of COVID-19 was not affected by DMTs, neurological disabilities, and comorbidities.
Conclusions: In this single-center POMS series, the small subgroup of patients who had contacted the SARS-CoV-2 virus or developed COVID-19 had reported no or mild symptoms. This may be partly related to the infrequent use of rituximab in this group. Our results corroborate those in adult-onset MS where no increased risk is reported for patients whose EDSS scores are <6 and who are not on B cell-depleting DMTs. Although less frequently than in adult MS, immunosuppressive DMTs may be needed in POMS; therefore, the importance of appropriate vaccination is to be underlined.
Keywords: COVID-19; Disease-modifying therapy; Pediatric-onset multiple sclerosis; Severity.