Sepúlveda Maria, Llufriu Sara, Martínez-Hernández Eugenia, Català Martí, Artola Montse, Hernando Ana, Montejo Carmen, Pulido-Valdeolivas Irene, Martínez-Heras Eloy, Guasp Mar, Solana Elisabeth, Llansó Laura, Escudero Domingo, Aldea Marta, Prats Clara, Graus Francesc, Blanco Yolanda, Saiz Albert
From the Neuroimmunology and Multiple Sclerosis Unit (M.S., S.L., E. Martínez-Hernández, M. Artola, A.H., C.M., I.P.-V., E. Martínez-Heras, M.G., E.S., L.L., D.E., Y.B., A.S.), Service of Neurology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), and Universitat de Barcelona; Comparative Medicine and Bioimage Centre of Catalonia (CMCiB) (M.C., C.P.), Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol; Department of Physics (M.C., C.P.), Universitat Politècnica de Catalunya; Preventive Medicine and Epidemiology Department (M. Aldea), Hospital Clinic of Barcelona, University of Barcelona; Neuroimmunology Program (F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); and Institut de Neurociències (A.S.), Universitat de Barcelona, Spain.
Neurol Neuroimmunol Neuroinflamm. 2021 Jan 27;8(2). doi: 10.1212/NXI.0000000000000954. Print 2021 Mar 4.
To investigate the incidence of coronavirus disease 2019 (COVID-19) in a single-center cohort of patients with MS and to explore the contribution of their comorbidities and therapies to the outcome.
A cross-sectional mixed-method study was conducted involving an email-based, self-administered questionnaire sent on May 21, 2020, to 586 patients with MS followed at the MS Unit of Hospital Clinic, University of Barcelona, along with telephone interview, and review of electronic medical records until June 18, 2020. The cumulative incidence of confirmed COVID-19 (positive PCR or antibody test) and all COVID-19 cases (confirmed and suspected) from the start of the pandemic was compared with the population estimates for Barcelona.
A total of 407 patients (69.5%) completed the survey. Most of the responders (67%) were female. The responders had a median age of 48 years (range 19-86), relapsing-remitting disease (84%), at least 1 comorbidity (45%), and were on disease-modifying therapy (DMT; 74.7%). COVID-19 was confirmed in 5 patients (1.2%) and suspected in 46 (11.3%). The cumulative incidence of confirmed COVID-19 cases was similar to that of the general population but was almost 2-fold higher when all cases were considered ( < 0.001). Six patients (11.7%) were hospitalized, of which 5 had good recovery and 1 died. Hospitalized patients were more frequently male, had diabetes and had progressive forms of MS ( < 0.05). DMT was not associated with the risk of infection or the outcome.
In the studied MS cohort, the incidence of COVID-19 was higher than that of the general population; however, most patients did not require hospitalization and had a good outcome despite the frequent presence of comorbidities and treatment with DMT.
调查巴塞罗那大学医院临床多发性硬化症科单中心队列中2019冠状病毒病(COVID-19)的发病率,并探讨其合并症和治疗方法对预后的影响。
开展一项横断面混合方法研究,于2020年5月21日通过电子邮件向巴塞罗那大学医院临床多发性硬化症科随访的586例多发性硬化症患者发送自填式问卷,同时进行电话访谈,并查阅电子病历,直至2020年6月18日。将确诊COVID-19(聚合酶链反应或抗体检测呈阳性)和自大流行开始以来所有COVID-19病例(确诊和疑似)的累积发病率与巴塞罗那的人群估计数进行比较。
共有407例患者(69.5%)完成了调查。大多数受访者(67%)为女性。受访者的中位年龄为48岁(范围19-86岁),复发缓解型疾病(84%),至少有一种合并症(45%),并接受疾病修正治疗(DMT;74.7%)。5例患者(1.2%)确诊COVID-19,46例(11.3%)疑似感染。确诊COVID-19病例的累积发病率与普通人群相似,但当考虑所有病例时,几乎高出2倍(<0.001)。6例患者(11.7%)住院,其中5例恢复良好,1例死亡。住院患者男性更为常见,患有糖尿病且患有进展型多发性硬化症(<0.05)。DMT与感染风险或预后无关。
在研究的多发性硬化症队列中,COVID-19的发病率高于普通人群;然而,尽管大多数患者经常合并症且接受DMT治疗,但大多数患者无需住院且预后良好。