Cargando…

Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic

During the COVID-19 pandemic and the related lockdowns, outpatient follow-up visits for patients with chronic neurological diseases have been suspended. Managing people affected by amyotrophic lateral sclerosis (ALS) has become highly complicated, leaving patients without the standard multidisciplin...

Descripción completa

Detalles Bibliográficos
Autores principales: De Marchi, Fabiola, Gallo, Chiara, Sarnelli, Maria Francesca, De Marchi, Ilaria, Saraceno, Massimo, Cantello, Roberto, Mazzini, Letizia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534200/
https://www.ncbi.nlm.nih.gov/pubmed/34679356
http://dx.doi.org/10.3390/brainsci11101291
_version_ 1784587498247159808
author De Marchi, Fabiola
Gallo, Chiara
Sarnelli, Maria Francesca
De Marchi, Ilaria
Saraceno, Massimo
Cantello, Roberto
Mazzini, Letizia
author_facet De Marchi, Fabiola
Gallo, Chiara
Sarnelli, Maria Francesca
De Marchi, Ilaria
Saraceno, Massimo
Cantello, Roberto
Mazzini, Letizia
author_sort De Marchi, Fabiola
collection PubMed
description During the COVID-19 pandemic and the related lockdowns, outpatient follow-up visits for patients with chronic neurological diseases have been suspended. Managing people affected by amyotrophic lateral sclerosis (ALS) has become highly complicated, leaving patients without the standard multidisciplinary follow-up. This study aimed to analyze the impact of the COVID-19 lockdown on ALS disease progression. We compared the clinical data and progression in the first year following diagnosis for patients who received ALS diagnosis during 2020 (G20, N = 34), comparing it with a group of diagnosed in 2018 (G18, N = 31). Both groups received a comparable multidisciplinary model of care in our Tertiary Expert ALS Centre, Novara, Italy. The monthly rate of ALSFRS-R decline during the lockdown was significantly increased in G20 compared to G18 (1.52 ± 2.69 vs. 0.76 ± 0.56; p-value: 0.005). In G20, 47% required non-invasive ventilation (vs. 32% of G18). Similarly, in G20, 35% of patients died vs. 19% of patients in G18 (p-value: 0.01). All results were corrected for gender, age, site of onset, and diagnostic delay. Several factors can be implicated in making ALS more severe, with a faster progression, such as reduced medical evaluations and the possibility of therapeutic changes, social isolation, and rehabilitation therapy suspension.
format Online
Article
Text
id pubmed-8534200
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-85342002021-10-23 Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic De Marchi, Fabiola Gallo, Chiara Sarnelli, Maria Francesca De Marchi, Ilaria Saraceno, Massimo Cantello, Roberto Mazzini, Letizia Brain Sci Article During the COVID-19 pandemic and the related lockdowns, outpatient follow-up visits for patients with chronic neurological diseases have been suspended. Managing people affected by amyotrophic lateral sclerosis (ALS) has become highly complicated, leaving patients without the standard multidisciplinary follow-up. This study aimed to analyze the impact of the COVID-19 lockdown on ALS disease progression. We compared the clinical data and progression in the first year following diagnosis for patients who received ALS diagnosis during 2020 (G20, N = 34), comparing it with a group of diagnosed in 2018 (G18, N = 31). Both groups received a comparable multidisciplinary model of care in our Tertiary Expert ALS Centre, Novara, Italy. The monthly rate of ALSFRS-R decline during the lockdown was significantly increased in G20 compared to G18 (1.52 ± 2.69 vs. 0.76 ± 0.56; p-value: 0.005). In G20, 47% required non-invasive ventilation (vs. 32% of G18). Similarly, in G20, 35% of patients died vs. 19% of patients in G18 (p-value: 0.01). All results were corrected for gender, age, site of onset, and diagnostic delay. Several factors can be implicated in making ALS more severe, with a faster progression, such as reduced medical evaluations and the possibility of therapeutic changes, social isolation, and rehabilitation therapy suspension. MDPI 2021-09-29 /pmc/articles/PMC8534200/ /pubmed/34679356 http://dx.doi.org/10.3390/brainsci11101291 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
De Marchi, Fabiola
Gallo, Chiara
Sarnelli, Maria Francesca
De Marchi, Ilaria
Saraceno, Massimo
Cantello, Roberto
Mazzini, Letizia
Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic
title Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic
title_full Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic
title_fullStr Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic
title_full_unstemmed Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic
title_short Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic
title_sort accelerated early progression of amyotrophic lateral sclerosis over the covid-19 pandemic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534200/
https://www.ncbi.nlm.nih.gov/pubmed/34679356
http://dx.doi.org/10.3390/brainsci11101291
work_keys_str_mv AT demarchifabiola acceleratedearlyprogressionofamyotrophiclateralsclerosisoverthecovid19pandemic
AT gallochiara acceleratedearlyprogressionofamyotrophiclateralsclerosisoverthecovid19pandemic
AT sarnellimariafrancesca acceleratedearlyprogressionofamyotrophiclateralsclerosisoverthecovid19pandemic
AT demarchiilaria acceleratedearlyprogressionofamyotrophiclateralsclerosisoverthecovid19pandemic
AT saracenomassimo acceleratedearlyprogressionofamyotrophiclateralsclerosisoverthecovid19pandemic
AT cantelloroberto acceleratedearlyprogressionofamyotrophiclateralsclerosisoverthecovid19pandemic
AT mazziniletizia acceleratedearlyprogressionofamyotrophiclateralsclerosisoverthecovid19pandemic