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Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia

BACKGROUND: When the novel coronavirus disease 2019 (COVID-19) appeared, concerns about its course in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) arose. This study aimed to evaluate the incidence, severity and risk factors of the more severe COVID-19 cour...

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Autores principales: Stastna, Dominika, Menkyova, Ingrid, Drahota, Jiri, Mazouchova, Aneta, Adamkova, Jana, Ampapa, Radek, Grunermelova, Marketa, Peterka, Marek, Recmanova, Eva, Rockova, Petra, Rous, Matous, Stetkarova, Ivana, Valis, Martin, Vachova, Marta, Woznicova, Ivana, Horakova, Dana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier B.V. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223114/
https://www.ncbi.nlm.nih.gov/pubmed/34216998
http://dx.doi.org/10.1016/j.msard.2021.103104
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author Stastna, Dominika
Menkyova, Ingrid
Drahota, Jiri
Mazouchova, Aneta
Adamkova, Jana
Ampapa, Radek
Grunermelova, Marketa
Peterka, Marek
Recmanova, Eva
Rockova, Petra
Rous, Matous
Stetkarova, Ivana
Valis, Martin
Vachova, Marta
Woznicova, Ivana
Horakova, Dana
author_facet Stastna, Dominika
Menkyova, Ingrid
Drahota, Jiri
Mazouchova, Aneta
Adamkova, Jana
Ampapa, Radek
Grunermelova, Marketa
Peterka, Marek
Recmanova, Eva
Rockova, Petra
Rous, Matous
Stetkarova, Ivana
Valis, Martin
Vachova, Marta
Woznicova, Ivana
Horakova, Dana
author_sort Stastna, Dominika
collection PubMed
description BACKGROUND: When the novel coronavirus disease 2019 (COVID-19) appeared, concerns about its course in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) arose. This study aimed to evaluate the incidence, severity and risk factors of the more severe COVID-19 course among MS and NMOSD patients. METHODS: From March 1, 2020, to February 28, 2021, 12 MS centres, representing 70% of the Czech MS and NMOSD population, reported laboratory-confirmed COVID-19 cases via the Czech nationwide register of MS and NMOSD patients (ReMuS). The main outcome was COVID-19 severity assessed on an 8-point scale with a cut-off at 4 (radiologically confirmed pneumonia) according to the World Health Organisation´s (WHO) COVID-19 severity assessment. RESULTS: We identified 958 MS and 13 NMOSD patients, 50 MS and 4 NMOSD patients had pneumonia, 3 MS and 2 NMOSD patients died. The incidence of COVID-19 among patients with MS seems to be similar to the general Czech population. A multivariate logistic regression determined that higher body mass index (BMI [OR 1.07, 95% CI, 1.00-1.14]), older age (OR per 10 years 2.01, 95% CI, 1.41-2.91), high-dose glucocorticoid treatment during the 2 months before COVID-19 onset (OR 2.83, 95% CI, 0.10-7.48) and anti-CD20 therapy (OR 7.04, 95% CI, 3.10-15.87) were independent variables associated with pneumonia in MS patients. Increase odds of pneumonia in anti-CD20 treated MS patients compared to patients with other disease-modifying therapy (same age, sex, BMI, high-dose glucocorticoid treatment during the 2 months before COVID-19 onset, presence of pulmonary comorbidity) were confirmed by propensity score matching (OR 8.90, 95% CI, 3.04-33.24). Reports on COVID-19 infection in patients with NMOSD are scarce, however, data available up to now suggest a high risk of a more severe COVID-19 course as well as a higher mortality rate among NMOSD patients. In our cohort, 4 NMOSD patients (30.77%) had the more severe COVID-19 course and 2 patients (15.39%) died. CONCLUSION: : The majority of MS patients had a mild COVID-19 course contrary to NMOSD patients, however, higher BMI and age, anti-CD20 therapy and high-dose glucocorticoid treatment during the 2 months before COVID-19 onset were associated with pneumonia. Based on this study, we have already started an early administration of anti-SARS-CoV-2 monoclonal antibodies and preferential vaccination in the risk group of patients.
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spelling pubmed-82231142021-06-25 Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia Stastna, Dominika Menkyova, Ingrid Drahota, Jiri Mazouchova, Aneta Adamkova, Jana Ampapa, Radek Grunermelova, Marketa Peterka, Marek Recmanova, Eva Rockova, Petra Rous, Matous Stetkarova, Ivana Valis, Martin Vachova, Marta Woznicova, Ivana Horakova, Dana Mult Scler Relat Disord Original Research Article BACKGROUND: When the novel coronavirus disease 2019 (COVID-19) appeared, concerns about its course in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) arose. This study aimed to evaluate the incidence, severity and risk factors of the more severe COVID-19 course among MS and NMOSD patients. METHODS: From March 1, 2020, to February 28, 2021, 12 MS centres, representing 70% of the Czech MS and NMOSD population, reported laboratory-confirmed COVID-19 cases via the Czech nationwide register of MS and NMOSD patients (ReMuS). The main outcome was COVID-19 severity assessed on an 8-point scale with a cut-off at 4 (radiologically confirmed pneumonia) according to the World Health Organisation´s (WHO) COVID-19 severity assessment. RESULTS: We identified 958 MS and 13 NMOSD patients, 50 MS and 4 NMOSD patients had pneumonia, 3 MS and 2 NMOSD patients died. The incidence of COVID-19 among patients with MS seems to be similar to the general Czech population. A multivariate logistic regression determined that higher body mass index (BMI [OR 1.07, 95% CI, 1.00-1.14]), older age (OR per 10 years 2.01, 95% CI, 1.41-2.91), high-dose glucocorticoid treatment during the 2 months before COVID-19 onset (OR 2.83, 95% CI, 0.10-7.48) and anti-CD20 therapy (OR 7.04, 95% CI, 3.10-15.87) were independent variables associated with pneumonia in MS patients. Increase odds of pneumonia in anti-CD20 treated MS patients compared to patients with other disease-modifying therapy (same age, sex, BMI, high-dose glucocorticoid treatment during the 2 months before COVID-19 onset, presence of pulmonary comorbidity) were confirmed by propensity score matching (OR 8.90, 95% CI, 3.04-33.24). Reports on COVID-19 infection in patients with NMOSD are scarce, however, data available up to now suggest a high risk of a more severe COVID-19 course as well as a higher mortality rate among NMOSD patients. In our cohort, 4 NMOSD patients (30.77%) had the more severe COVID-19 course and 2 patients (15.39%) died. CONCLUSION: : The majority of MS patients had a mild COVID-19 course contrary to NMOSD patients, however, higher BMI and age, anti-CD20 therapy and high-dose glucocorticoid treatment during the 2 months before COVID-19 onset were associated with pneumonia. Based on this study, we have already started an early administration of anti-SARS-CoV-2 monoclonal antibodies and preferential vaccination in the risk group of patients. Elsevier B.V. 2021-09 2021-06-24 /pmc/articles/PMC8223114/ /pubmed/34216998 http://dx.doi.org/10.1016/j.msard.2021.103104 Text en © 2021 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Research Article
Stastna, Dominika
Menkyova, Ingrid
Drahota, Jiri
Mazouchova, Aneta
Adamkova, Jana
Ampapa, Radek
Grunermelova, Marketa
Peterka, Marek
Recmanova, Eva
Rockova, Petra
Rous, Matous
Stetkarova, Ivana
Valis, Martin
Vachova, Marta
Woznicova, Ivana
Horakova, Dana
Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia
title Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia
title_full Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia
title_fullStr Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia
title_full_unstemmed Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia
title_short Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia
title_sort multiple sclerosis, neuromyelitis optica spectrum disorder and covid-19: a pandemic year in czechia
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223114/
https://www.ncbi.nlm.nih.gov/pubmed/34216998
http://dx.doi.org/10.1016/j.msard.2021.103104
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