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COVID-19 大流行期间 ms 和 nmosd 患者管理的决策:一项拉丁美洲调查。

Decision-making on management of ms and nmosd patients during the COVID-19 pandemic: A latin american survey.

机构信息

Centro Universitario de Esclerosis Múltiple (CUEM), Hospital Ramos Mejía, Facultad de Medicina, Universidad de Buenos Aires, Urquiza número 609, CABA, C1221 ADC, Argentina; División Neurología, Sanatorio Güemes, CABA.

Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina.

出版信息

Mult Scler Relat Disord. 2020 Sep;44:102310. doi: 10.1016/j.msard.2020.102310. Epub 2020 Jun 20.

Abstract

BACKGROUND

The emergence of COVID-19 and its vertiginous spreading speed represents a unique challenge to neurologists managing multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). The need for data on the impact of the virus on these patients grows rapidly. There is an urgent necessity of sharing information to enable evidence-based decision making on the clinical management. There are no data on what physicians are doing on clinical practice in Latin American countries.

AIM

to investigate current management opinion of Latin American MS and/or NMOSD expert neurologists based on their experience and recommendations.

METHODS

we developed a voluntary web-based survey based on hypothetical situations that these patients may encounter, while taking into account the potential risk of developing severe COVID-19 infection.

RESULTS

60% of the experts had the possibility of monitoring their patients by telemedicine. Most neurologists postpone magnetic resonance. Laboratory blood tests delay is associated with the type of treatment. Platform therapies, dimethyl-fumarate and natalizumab are considered safe options to initiate in naive patients.

CONCLUSION

decision-making about MS and NMOSD patients has become even more complex in order to adapt to the COVID-19 pandemic. Risks and benefits should be taken into consideration throughout the patient follow-up.

摘要

背景

COVID-19 的出现及其令人眩晕的传播速度,对管理多发性硬化症 (MS) 和视神经脊髓炎谱系障碍 (NMOSD) 的神经科医生来说是一个独特的挑战。关于病毒对这些患者影响的数据需求迅速增长。迫切需要分享信息,以便在临床管理方面做出基于证据的决策。关于拉丁美洲国家的医生在临床实践中正在做什么,目前尚无数据。

目的

基于经验和建议,调查拉丁美洲 MS 和/或 NMOSD 专家神经病学家目前的管理意见。

方法

我们根据这些患者可能遇到的假设情况制定了一项自愿的网络调查,同时考虑了发生严重 COVID-19 感染的潜在风险。

结果

60%的专家有可能通过远程医疗对患者进行监测。大多数神经科医生会推迟磁共振检查。实验室血液检查的延迟与治疗类型有关。平台疗法、二甲基富马酸和那他珠单抗被认为是在初治患者中安全的选择。

结论

为了适应 COVID-19 大流行,MS 和 NMOSD 患者的决策制定变得更加复杂。在整个患者随访过程中,应考虑风险和获益。

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