Möhn Nora, Konen Franz F, Pul Refik, Kleinschnitz Christoph, Prüss Harald, Witte Torsten, Stangel Martin, Skripuletz Thomas
Department of Neurology, Hanover Medical School, 30625 Hannover, Germany.
Department of Neurology, University Hospital Essen, 45147 Essen, Germany.
J Clin Med. 2020 Dec 16;9(12):4067. doi: 10.3390/jcm9124067.
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic is a challenge for all participants in the healthcare system. At the beginning of the pandemic, many physicians asked themselves what risk their patients, especially those with chronic diseases, were exposed to. We present an overview of all patients with multiple sclerosis (MS) and SARS-CoV-2 infection published in the literature so far. In total, there are publications on 873 SARS-CoV-2 positive MS patients and information on the outcome can be given for 700 patients. With regard to the different disease modifying therapies (DMTs), by far the most cases were described under anti-CD20 treatment ( = 317). The mortality rate of all MS patients was 4% and a further 3% required invasive or non-invasive ventilation. When looking at the severe and fatal cases, it is particularly noticeable that patients without DMTs, with previous cardiovascular diseases, or with a severe degree of disability are at risk. Immunosuppressive therapy itself does not appear to be a substantial risk factor. Rather, it is reasonable to assume that the therapies could be protective, either directly, by mitigating the cytokine storm, or indirectly, by reducing the disease activity of MS.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行对医疗系统的所有参与者都是一项挑战。在大流行初期，许多医生问自己，他们的患者，尤其是那些患有慢性病的患者，面临着怎样的风险。我们对迄今为止文献中发表的所有多发性硬化症（MS）患者和SARS-CoV-2感染情况进行了综述。总共发表了关于873例SARS-CoV-2阳性MS患者的文章，并且可以给出700例患者的预后信息。关于不同的疾病修正疗法（DMTs），到目前为止，抗CD20治疗下描述的病例最多（=317例）。所有MS患者的死亡率为4%，另有3%的患者需要有创或无创通气。在观察重症和死亡病例时，特别值得注意的是，未接受DMTs治疗、既往有心血管疾病或残疾程度严重的患者有风险。免疫抑制治疗本身似乎不是一个重大风险因素。相反，有理由认为这些疗法可能具有保护作用，要么通过减轻细胞因子风暴直接起到保护作用，要么通过降低MS的疾病活动间接起到保护作用。
