Alfred Health, Clinical Neurosciences, Melbourne, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne Australia.
Alfred Health, Clinical Neurosciences, Melbourne, Australia.
Mult Scler Relat Disord. 2020 Oct;45:102338. doi: 10.1016/j.msard.2020.102338. Epub 2020 Jun 24.
The global COVID-19 pandemic creates an obvious acute health care resourcing and response problem. The different timing of pandemic peak in geographically distinct locations creates a short window of response opportunity. Rapid dissemination of medical information from early affected areas to later ones is therefore crucial to optimise planning. Formulating the best system response for at-risk patient populations is especially complex. People with multiple sclerosis (pwMS) are exposed to long-term immunosuppressive disease modifying treatments (DMTs) and, in theory, could be at increased risk of contracting the virus and developing complications. Social media, such as Twitter, can provide a global platform to rapidly share information and individual experiences.
This report summarizes the case experience of pwMS with COVID-19 infection in the first month of the pandemic as reported on Twitter using the #MSCOVID19 hashtag. 26 individual cases of COVID-19 in pwMS were reported from Europe and the United States of America. The cases involved a combination of relapsing and progressive MS phenotypes treated with a range of DMT (5 anti CD20 therapy, 4 cladribine, 4 fingolimod, 4 injectables, 3 alemtuzumab, 2 dimethyl fumarate, 2 untreated, 1 teriflunomide, 1 natalizumab). The cases shared present the earliest reported data on outcomes of COVID-19 infection in pwMS. Whilst limited, the cautiously reassuring nature of these early cases assisted in clinical management by allowing neurologists to continuously reassess their approach to DMT management.
全球 COVID-19 大流行带来了明显的急性医疗资源和应对问题。地理位置不同的地区大流行高峰期的时间不同,这为应对提供了一个短暂的窗口期。因此,迅速将医疗信息从早期受影响地区传播到后期地区对于优化规划至关重要。为高危患者群体制定最佳的系统应对方案尤其复杂。多发性硬化症(pwMS)患者长期接受免疫抑制性疾病修正治疗(DMT),理论上他们感染病毒并出现并发症的风险可能会增加。社交媒体,如 Twitter,可以为快速共享信息和个人经验提供一个全球平台。
本报告总结了在大流行的第一个月中,通过#MSCOVID19 标签在 Twitter 上报告的患有 COVID-19 的 pwMS 的病例经验。报告了来自欧洲和美国的 26 例 pwMS 中 COVID-19 的病例。这些病例涉及多种 MS 表型(复发缓解型和进展型),使用了多种 DMT(5 种抗 CD20 治疗、4 种克拉屈滨、4 种芬戈莫德、4 种注射剂、3 种阿仑单抗、2 种富马酸二甲酯、2 种未治疗、1 种特立氟胺、1 种那他珠单抗)。这些病例分享了最早报告的 pwMS 中 COVID-19 感染结果的数据。尽管数量有限,但这些早期病例的谨慎性令人欣慰的性质有助于临床管理,使神经科医生能够不断重新评估他们对 DMT 管理的方法。