Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris, France.
Pole des Neurosciences, B4 Neurology Unit, Centre de ressources et de compétences Sclérose en plaques, CHU Purpan, Toulouse, France.
Eur J Neurol. 2021 Oct;28(10):3461-3466. doi: 10.1111/ene.14612. Epub 2020 Nov 27.
Outcomes of coronavirus disease 2019 (COVID-19) in patients with neuromyelitis optica spectrum disorders (NMOSD) or myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), often treated with immunosuppressive therapies, are still unknown.
We conducted a multicenter, retrospective, observational cohort study among all French expert centers for neuromyelitis optica and related disorders. Patients with NMOSD or MOGAD included in the study received a confirmed or highly suspected diagnosis of COVID-19 between 1 March 2020 and 30 June 2020. Main outcome was COVID-19 severity score assessed on a seven-point ordinal scale ranging from 1 (not hospitalized with no limitations on activities) to 7 (death).
Fifteen cases (mean [SD] age: 39.3 [14.3] years, 11 female) were included. Five patients (33.3%) were hospitalized, all receiving rituximab. A 24-year-old patient with positive aquaporine-4 antibody, with obesity as comorbidity, needed mechanical ventilation. Outpatients were receiving anti-CD20 (5), mycophenolate mofetil (3) or azathioprine (3). They were younger (mean [SD] age: 37.0 [13.4] years), with a longer disease duration (mean [SD]: 8.3 [6.3] years) and had a lower expanded disability severity score (EDSS) score (median [range] EDSS: 2.5 [0-4]) relative to patients requiring hospitalization (mean [SD] age: 44.0 [16.4] years, mean [SD] disease duration: 5.8 [5.5] years, median [range] EDSS: 4 [0-6.5]).
COVID-19 outcome was overall favorable in this cohort. Larger international studies are needed to identify risk factors of severe COVID-19; however, we recommend personal protective measures to reduce risk of SARS-CoV-2 infection in this immunocompromised population.
患有视神经脊髓炎谱系疾病（NMOSD）或髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）的患者经常接受免疫抑制治疗，其 2019 年冠状病毒病（COVID-19）的结局尚不清楚。
我们在所有法国视神经脊髓炎和相关疾病专家中心进行了一项多中心、回顾性、观察性队列研究。研究纳入的 NMOSD 或 MOGAD 患者于 2020 年 3 月 1 日至 6 月 30 日期间确诊或高度疑似 COVID-19。主要结局是采用 7 分序数量表评估的 COVID-19 严重程度评分，范围为 1（未住院且活动不受限制）至 7（死亡）。
纳入 15 例患者（平均[SD]年龄：39.3[14.3]岁，11 例女性）。5 例患者（33.3%）住院，均接受利妥昔单抗治疗。1 例 24 岁、抗水通道蛋白-4 抗体阳性、肥胖合并症的患者需要机械通气。门诊患者接受抗 CD20（5 例）、霉酚酸酯（3 例）或硫唑嘌呤（3 例）治疗。与需要住院治疗的患者相比，门诊患者年龄更小（平均[SD]年龄：37.0[13.4]岁）、疾病持续时间更长（平均[SD]：8.3[6.3]年）、扩展残疾严重程度评分（EDSS）更低（中位数[范围]EDSS：2.5[0-4]）。
该队列中 COVID-19 的结局总体良好。需要更大规模的国际研究来确定严重 COVID-19 的危险因素；然而，我们建议该免疫功能低下人群采取个人防护措施，以降低 SARS-CoV-2 感染的风险。
