Fernandes Peter M, O'Neill Martin, Kearns Patrick K A, Pizzo Sinforosa, Watters Chrissie, Baird Stuart, MacDougall Niall J J, Hunt David P J
Anne Rowling Clinic, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Clinical & Protecting Health Directorate, Public Health Scotland, Edinburgh, UK.
Wellcome Open Res. 2020 Nov 25;5:276. doi: 10.12688/wellcomeopenres.16349.1. eCollection 2020.
: The impact of the coronavirus disease 2019 (COVID-19) pandemic on people with multiple sclerosis (MS) is a major current concern, in particular the risk of death. Here we describe the impact of the first wave of COVID-19 infections (Mar 2020-July 2020) on the Scottish MS Register (SMSR) population, a cohort of 4702 individuals with MS, all newly diagnosed in the past decade. : We established a clinician alert system, linking the SMSR with the Electronic Communication of Surveillance in Scotland (ECOSS). This allows identification of patients within this cohort who had a positive SARS-CoV-2 PCR test. The SMSR was also linked to death records from National Records Scotland. : Of 4702 people with MS, 246 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR tests were performed, of which 17 were positive. The proportion of positive tests were similar to the general Scotland population (Observed PCR confirmed cases = 17, expected = 17.5, O/E = 0.97, 95% CI: 0.60 - 1.56, =.90). Between 1 March - 31 July 2020 12 individuals on the SMSR died, 5 of which were linked to COVID-19 (1 PCR confirmed, 4 clinical diagnoses without PCR confirmation). This number of COVID-19-related deaths was higher than expected (observed deaths = 5, expected deaths = 1.2, O/E = 4.03, 95% CI = 1.48 - 8.94, =.01). All COVID-19-related deaths in the SMSR occurred in individuals with advanced disability (Expanded Disability Status Scale ≥7), and no deaths occurred in patients receiving disease modifying therapy (DMT) therapies. : In this nationally comprehensive cohort of MS patients diagnosed in Scotland within the past 10 years, we observed similar rates of PCR-confirmed SARS-CoV-2 infection compared to the general Scottish population, but a small number of excess COVID-19 related deaths. These deaths occurred in individuals with advanced disability who were not receiving DMTs.
2019冠状病毒病（COVID-19）大流行对多发性硬化症（MS）患者的影响是当前主要关注的问题，尤其是死亡风险。在此，我们描述了第一波COVID-19感染（2020年3月至2020年7月）对苏格兰MS登记册（SMSR）人群的影响，该人群包括4702名MS患者，均在过去十年中首次确诊。我们建立了一个临床医生警报系统，将SMSR与苏格兰电子监测通信（ECOSS）相连接。这使得能够识别该队列中SARS-CoV-2 PCR检测呈阳性的患者。SMSR还与苏格兰国家记录中的死亡记录相连接。在4702名MS患者中，进行了246次严重急性呼吸综合征冠状病毒2（SARS-CoV-2）PCR检测，其中17次呈阳性。阳性检测比例与苏格兰普通人群相似（观察到的PCR确诊病例 = 17，预期 = 17.5，O/E = 0.97，95% CI：0.60 - 1.56，P = 0.90）。在2020年3月1日至7月31日期间，SMSR上有12人死亡，其中5人与COVID-19相关（1例PCR确诊，4例临床诊断但无PCR确认）。这一数量的COVID-19相关死亡高于预期（观察到的死亡 = 5，预期死亡 = 1.2，O/E = 4.03，95% CI = 1.48 - 8.94，P = 0.01）。SMSR中所有与COVID-19相关的死亡均发生在残疾程度较高的个体（扩展残疾状态量表≥7）中，接受疾病修饰治疗（DMT）的患者中无死亡发生。在这个过去10年内在苏格兰确诊的全国性综合MS患者队列中，我们观察到与苏格兰普通人群相比，PCR确诊的SARS-CoV-2感染率相似，但有少量额外的与COVID-19相关的死亡。这些死亡发生在未接受DMT治疗的残疾程度较高的个体中。
