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The disease course of multiple sclerosis before and during COVID-19 pandemic: A retrospective five-year study

INTRODUCTION: COVID-19 pandemic is thought to influence the natural history of immune disorders, yet the knowledge on its effect on multiple sclerosis (MS) is unknown and not fully understood for which we conducted this retrospective study. METHODS AND MATERIALS: We included all patients with MS see...

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Autores principales: Babtain, Fawzi, Bajafar, Abdulaziz, Nazmi, Ohoud, Badawi, Manal, Basndwah, Ahmed, Bushnag, Areej, Cupler, Edward, Hassan, Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier B.V. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9212895/
https://www.ncbi.nlm.nih.gov/pubmed/35759904
http://dx.doi.org/10.1016/j.msard.2022.103985
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author Babtain, Fawzi
Bajafar, Abdulaziz
Nazmi, Ohoud
Badawi, Manal
Basndwah, Ahmed
Bushnag, Areej
Cupler, Edward
Hassan, Ahmed
author_facet Babtain, Fawzi
Bajafar, Abdulaziz
Nazmi, Ohoud
Badawi, Manal
Basndwah, Ahmed
Bushnag, Areej
Cupler, Edward
Hassan, Ahmed
author_sort Babtain, Fawzi
collection PubMed
description INTRODUCTION: COVID-19 pandemic is thought to influence the natural history of immune disorders, yet the knowledge on its effect on multiple sclerosis (MS) is unknown and not fully understood for which we conducted this retrospective study. METHODS AND MATERIALS: We included all patients with MS seen in King Faisal Specialist Hospital and Research Centre in Jeddah, Saudi Arabia, between January 2017 and October 20201. We determined clinical and radiological evidence of disease activities in all patients by the end of the study period, and we compared the disease patterns before and during the pandemic. We also identified patients with COVID-19 since March 2020, who had at least 3 months of follow-up following the infection. RESULTS: We studied 301 patients; 216 (72%) were women, the mean age was 38 years (range; 16, 73 years), the mean disease duration was 10 years (range; 1, 36 years), and the median EDSS score was 0.5 (range; 0, 8). RRMS accounted for most of the cases (270 patients). MS disease activities were 25% less prevalent during the pandemic compared to the preceding 3 years (26 vs. 51%, respectively, p < 0.01). Bivariate analysis showed significant higher disease activities in patients younger than 35 years (73 vs 27%), on DMT (68 vs 32%), and complaint to therapy (69 vs 31%). Multiple logistic regression analysis showed that the likelihood of MS disease activities were 3 times more during the pre-pandemic era (adjusted OR = 3.1, p value < 0.05, 95% CI; 1.4, 7.1). Thirty patients (10%) were infected with COVID-19. All patients reported mild symptoms, and none required hospitalization. COVID-19 was prevalent among younger patients with RRMS, with low EDSS scores, irrespective of DMTs they received. COVID-19 infection was not associated with clinical relapses or MRI changes. Disease activities were dependent on DMT use and not COVID-19 status. Multivariate analyses also confirmed no effect of COVID-19 on disease activities (p = 0.3 and 0.4, for clinical and MRI changes, respectively). CONCLUSIONS: MS disease activities did not increase during the pandemic, yet the apparent decrease in the disease activities is probably due to under reporting and not a real decrease in disease activities because of the pandemic. The COVID-19 infection in our MS patients showed a benign disease course, yet standard precautions to reduce the risk of COVID-19 transmission should be applied accordingly.
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spelling pubmed-92128952022-06-22 The disease course of multiple sclerosis before and during COVID-19 pandemic: A retrospective five-year study Babtain, Fawzi Bajafar, Abdulaziz Nazmi, Ohoud Badawi, Manal Basndwah, Ahmed Bushnag, Areej Cupler, Edward Hassan, Ahmed Mult Scler Relat Disord Original Article INTRODUCTION: COVID-19 pandemic is thought to influence the natural history of immune disorders, yet the knowledge on its effect on multiple sclerosis (MS) is unknown and not fully understood for which we conducted this retrospective study. METHODS AND MATERIALS: We included all patients with MS seen in King Faisal Specialist Hospital and Research Centre in Jeddah, Saudi Arabia, between January 2017 and October 20201. We determined clinical and radiological evidence of disease activities in all patients by the end of the study period, and we compared the disease patterns before and during the pandemic. We also identified patients with COVID-19 since March 2020, who had at least 3 months of follow-up following the infection. RESULTS: We studied 301 patients; 216 (72%) were women, the mean age was 38 years (range; 16, 73 years), the mean disease duration was 10 years (range; 1, 36 years), and the median EDSS score was 0.5 (range; 0, 8). RRMS accounted for most of the cases (270 patients). MS disease activities were 25% less prevalent during the pandemic compared to the preceding 3 years (26 vs. 51%, respectively, p < 0.01). Bivariate analysis showed significant higher disease activities in patients younger than 35 years (73 vs 27%), on DMT (68 vs 32%), and complaint to therapy (69 vs 31%). Multiple logistic regression analysis showed that the likelihood of MS disease activities were 3 times more during the pre-pandemic era (adjusted OR = 3.1, p value < 0.05, 95% CI; 1.4, 7.1). Thirty patients (10%) were infected with COVID-19. All patients reported mild symptoms, and none required hospitalization. COVID-19 was prevalent among younger patients with RRMS, with low EDSS scores, irrespective of DMTs they received. COVID-19 infection was not associated with clinical relapses or MRI changes. Disease activities were dependent on DMT use and not COVID-19 status. Multivariate analyses also confirmed no effect of COVID-19 on disease activities (p = 0.3 and 0.4, for clinical and MRI changes, respectively). CONCLUSIONS: MS disease activities did not increase during the pandemic, yet the apparent decrease in the disease activities is probably due to under reporting and not a real decrease in disease activities because of the pandemic. The COVID-19 infection in our MS patients showed a benign disease course, yet standard precautions to reduce the risk of COVID-19 transmission should be applied accordingly. Elsevier B.V. 2022-09 2022-06-20 /pmc/articles/PMC9212895/ /pubmed/35759904 http://dx.doi.org/10.1016/j.msard.2022.103985 Text en © 2022 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 Article
Babtain, Fawzi
Bajafar, Abdulaziz
Nazmi, Ohoud
Badawi, Manal
Basndwah, Ahmed
Bushnag, Areej
Cupler, Edward
Hassan, Ahmed
The disease course of multiple sclerosis before and during COVID-19 pandemic: A retrospective five-year study
title The disease course of multiple sclerosis before and during COVID-19 pandemic: A retrospective five-year study
title_full The disease course of multiple sclerosis before and during COVID-19 pandemic: A retrospective five-year study
title_fullStr The disease course of multiple sclerosis before and during COVID-19 pandemic: A retrospective five-year study
title_full_unstemmed The disease course of multiple sclerosis before and during COVID-19 pandemic: A retrospective five-year study
title_short The disease course of multiple sclerosis before and during COVID-19 pandemic: A retrospective five-year study
title_sort disease course of multiple sclerosis before and during covid-19 pandemic: a retrospective five-year study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9212895/
https://www.ncbi.nlm.nih.gov/pubmed/35759904
http://dx.doi.org/10.1016/j.msard.2022.103985
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