Division of Clinical Neurophysiology and Epilepsy Center, Ospedale Policlinico San Martino, IRCCS, Largo R. Benzi 10, 16132, Genoa, Italy.
Department of Neuroradiology, Ospedale Policlinico San Martino, IRCCS, Genoa, Italy.
Neurol Sci. 2021 Apr;42(4):1231-1236. doi: 10.1007/s10072-020-04997-z. Epub 2021 Jan 14.
Factors influencing self-perceived health status over Corona Virus Disease 2019 (COVID-19) emergency in vulnerable populations, such as patients with chronic neurological diseases, are still unknown. In this work, we aimed at testing whether clinical care changes imposed by the quarantine, together with certain demographic and disease-specific features, might have determined a self-perceived worsening of health status in patients with amyotrophic lateral sclerosis (ALS).
A brief web-based questionnaire investigating self-perceived anxiety, depression, and motor worsening, as well as clinical care changes over COVID-19 emergency, was administered to ALS patients currently followed at San Martino Hospital. Ordinal and logistic regression analyses were applied to identify significant predictors of health status.
Fifty-seven ALS patients completed the questionnaire. A total of 35.08% of cases reported anxiety symptoms, 36.84% depressive symptoms, and 35.08% reported worsening of motor symptoms. Significant predictors of anxiety symptoms severity included female gender, greater motor impairment, more aggressive disease course, and rehabilitation therapy suspension. The only significant predictor of depressive symptoms severity was a more aggressive disease course. Significant predictors of motor worsening were shorter disease duration and exams/visits cancelation.
COVID-19 emergency and its management exerted a significant impact on self-perceived health status in patients with ALS, particularly in those cases in the earliest disease phases and with a more aggressive disease course. These findings have potential to improve personalized medicine strategies in the next phase.
在易受影响的人群中，如患有慢性神经疾病的患者，影响他们对 2019 年冠状病毒病（COVID-19）紧急情况的自我感知健康状况的因素尚不清楚。在这项工作中，我们旨在测试隔离所施加的临床护理变化，以及某些人口统计学和疾病特异性特征，是否可能导致肌萎缩侧索硬化症（ALS）患者自我感知健康状况恶化。
通过一个简短的基于网络的问卷，调查 ALS 患者在 COVID-19 紧急情况下自我感知的焦虑、抑郁和运动恶化情况，以及临床护理变化。应用有序和逻辑回归分析来确定健康状况的显著预测因素。
57 名 ALS 患者完成了问卷。共有 35.08%的病例报告有焦虑症状，36.84%有抑郁症状，35.08%报告运动症状恶化。焦虑症状严重程度的显著预测因素包括女性性别、更大的运动障碍、更具侵袭性的疾病过程和康复治疗暂停。抑郁症状严重程度的唯一显著预测因素是更具侵袭性的疾病过程。运动恶化的显著预测因素是疾病持续时间较短和检查/就诊取消。
COVID-19 紧急情况及其管理对 ALS 患者的自我感知健康状况产生了重大影响，特别是在疾病早期阶段和疾病过程更具侵袭性的患者中。这些发现有可能在未来阶段改善个性化医疗策略。
