Multiple Sclerosis Center and Center for Translational & Computational Neuroimmunology, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA.
New York Presbyterian Hospital, New York, New York, USA.
Ann Clin Transl Neurol. 2021 Apr;8(4):918-928. doi: 10.1002/acn3.51314. Epub 2021 Feb 22.
To report initial results of a planned multicenter year-long prospective study examining the risk and impact of COVID-19 among persons with neuroinflammatory disorders (NID), particularly multiple sclerosis (MS).
In April 2020, we deployed online questionnaires to individuals in their home environment to assess the prevalence and potential risk factors of suspected COVID-19 in persons with NID (PwNID) and change in their neurological care.
Our cohort included 1115 participants (630 NID, 98% MS; 485 reference) as of 30 April 2020. 202 (18%) participants, residing in areas with high COVID-19 case prevalence, met the April 2020 CDC symptom criteria for suspected COVID-19, but only 4% of all participants received testing given testing shortages. Among all participants, those with suspected COVID-19 were younger, more racially diverse, and reported more depression and liver disease. PwNID had the same rate of suspected COVID-19 as the reference group. Early changes in disease management included telemedicine visits in 21% and treatment changes in 9% of PwNID. After adjusting for potential confounders, increasing neurological disability was associated with a greater likelihood of suspected COVID-19 (OR = 1.45, 1.17-1.84).
Our study of real-time, patient-reported experience during the COVID-19 pandemic complements physician-reported MS case registries which capture an excess of severe cases. Overall, PwNID seem to have a risk of suspected COVID-19 similar to the reference population.
报告一项计划中的多中心、为期一年的前瞻性研究的初步结果，该研究旨在检查神经炎症性疾病（NID）患者（尤其是多发性硬化症[MS]患者）中 COVID-19 的风险和影响。
2020 年 4 月，我们通过在线问卷向居家的个人进行调查，以评估 NID 患者（PwNID）中疑似 COVID-19 的患病率和潜在危险因素，以及他们的神经护理变化。
截至 2020 年 4 月 30 日，我们的队列包括 1115 名参与者（630 名 NID，98%为 MS；485 名对照）。202 名（18%）参与者居住在 COVID-19 病例高发地区，符合 2020 年 4 月 CDC 疑似 COVID-19 的症状标准，但由于检测短缺，只有 4%的参与者接受了检测。在所有参与者中，疑似 COVID-19 患者更年轻、种族更加多样化，并且报告了更多的抑郁和肝脏疾病。PwNID 的疑似 COVID-19 发生率与对照组相同。疾病管理的早期变化包括 21%的远程医疗访问和 9%的 PwNID 治疗改变。在校正潜在混杂因素后，神经功能障碍加重与疑似 COVID-19 的可能性增加相关（OR=1.45，1.17-1.84）。
我们对 COVID-19 大流行期间实时、患者报告的体验的研究补充了医生报告的 MS 病例登记，后者捕获了过多的严重病例。总体而言，PwNID 似乎具有与对照人群相似的疑似 COVID-19 风险。
