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The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk
There is an increasing need for better understanding of the impact of coronavirus disease 2019 (COVID-19) on patients with neuromyelitis optica spectrum disorder (NMOSD). A few pilot studies have investigated COVID-19 infections in NMOSD, but few studies have addressed disease activity and immune st...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019749/ https://www.ncbi.nlm.nih.gov/pubmed/33828524 http://dx.doi.org/10.3389/fneur.2021.657037 |
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author | Yin, Hexiang Zhang, Yao Xu, Yan Peng, Bin Cui, Liying Zhang, Shuyang |
author_facet | Yin, Hexiang Zhang, Yao Xu, Yan Peng, Bin Cui, Liying Zhang, Shuyang |
author_sort | Yin, Hexiang |
collection | PubMed |
description | There is an increasing need for better understanding of the impact of coronavirus disease 2019 (COVID-19) on patients with neuromyelitis optica spectrum disorder (NMOSD). A few pilot studies have investigated COVID-19 infections in NMOSD, but few studies have addressed disease activity and immune status of these patients during the pandemic. We carried out a cross-sectional study to examine immune status, relapses, and COVID-19 infections in a cohort of NMOSD patients using an electronic patient registry (MSNMOBase) for multiple sclerosis and related disorders. An online questionnaire was administered to all NMOSD patients in the registry from January 1, 2011, to June 1, 2020. Clinical demographic characteristics, immune status, relapses, treatments, COVID-19 infections, and preventive measures were evaluated. Of the 752 registered patients, 535 (71.1%) with qualified data were included. A total of 486 used preventive therapies during the pandemic, including mycophenolate mofetil (71.2%), azathioprine (13.3%), and other immunosuppressants (6.4%). Neither median immune cell counts nor immunoglobulin levels (p > 0.05) were significantly different between patients with or without immunosuppression. During the pandemic, no patients were diagnosed with COVID-19, and the majority (>95%) took one or more effective protective measures (e.g., wearing a mask and social distancing). However, a significantly higher annualized relapse rate (ARR) was observed in the 33 patients with treatment interruptions due to the pandemic compared to before it (p < 0.05), whereas ARR changes were not found in patients with continuous treatments or those without treatments (p > 0.05). Interruption frequency was significantly higher in patients with relapses compared to those without (34.9 vs. 15.7%, p < 0.01). For stable NMOSD patients during the pandemic, the risk of relapse due to treatment interruption may be higher than the risk of COVID-19 infection when protective measures are used, and continuous relapse-prevention treatments may be necessary. |
format | Online Article Text |
id | pubmed-8019749 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80197492021-04-06 The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk Yin, Hexiang Zhang, Yao Xu, Yan Peng, Bin Cui, Liying Zhang, Shuyang Front Neurol Neurology There is an increasing need for better understanding of the impact of coronavirus disease 2019 (COVID-19) on patients with neuromyelitis optica spectrum disorder (NMOSD). A few pilot studies have investigated COVID-19 infections in NMOSD, but few studies have addressed disease activity and immune status of these patients during the pandemic. We carried out a cross-sectional study to examine immune status, relapses, and COVID-19 infections in a cohort of NMOSD patients using an electronic patient registry (MSNMOBase) for multiple sclerosis and related disorders. An online questionnaire was administered to all NMOSD patients in the registry from January 1, 2011, to June 1, 2020. Clinical demographic characteristics, immune status, relapses, treatments, COVID-19 infections, and preventive measures were evaluated. Of the 752 registered patients, 535 (71.1%) with qualified data were included. A total of 486 used preventive therapies during the pandemic, including mycophenolate mofetil (71.2%), azathioprine (13.3%), and other immunosuppressants (6.4%). Neither median immune cell counts nor immunoglobulin levels (p > 0.05) were significantly different between patients with or without immunosuppression. During the pandemic, no patients were diagnosed with COVID-19, and the majority (>95%) took one or more effective protective measures (e.g., wearing a mask and social distancing). However, a significantly higher annualized relapse rate (ARR) was observed in the 33 patients with treatment interruptions due to the pandemic compared to before it (p < 0.05), whereas ARR changes were not found in patients with continuous treatments or those without treatments (p > 0.05). Interruption frequency was significantly higher in patients with relapses compared to those without (34.9 vs. 15.7%, p < 0.01). For stable NMOSD patients during the pandemic, the risk of relapse due to treatment interruption may be higher than the risk of COVID-19 infection when protective measures are used, and continuous relapse-prevention treatments may be necessary. Frontiers Media S.A. 2021-03-22 /pmc/articles/PMC8019749/ /pubmed/33828524 http://dx.doi.org/10.3389/fneur.2021.657037 Text en Copyright © 2021 Yin, Zhang, Xu, Peng, Cui and Zhang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Yin, Hexiang Zhang, Yao Xu, Yan Peng, Bin Cui, Liying Zhang, Shuyang The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk |
title | The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk |
title_full | The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk |
title_fullStr | The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk |
title_full_unstemmed | The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk |
title_short | The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk |
title_sort | impact of covid-19 on patients with neuromyelitis optica spectrum disorder beyond infection risk |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019749/ https://www.ncbi.nlm.nih.gov/pubmed/33828524 http://dx.doi.org/10.3389/fneur.2021.657037 |
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