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一项全国性多发性硬化症-新冠病毒研究的结果:土耳其多发性硬化症队列揭示了什么?

The outcome of a national MS-Covid-19 study: What the Turkish MS cohort reveals?

机构信息

Ondokuz Mayis University School of Medicine Samsun, Turkey.

Hacettepe University School of Medicine Ankara, Turkey.

出版信息

Mult Scler Relat Disord. 2021 Jul;52:102968. doi: 10.1016/j.msard.2021.102968. Epub 2021 Apr 18.

Abstract

BACKGROUND

The pandemic of the new type of corona virus infection 2019 [Covid-19] also affect people with Multiple Sclerosis (pwMS). Currently, the accumulating information on the effects of the infection regarding the demographic and clinical characteristics of the disease, as well as outcomes within different DMTs¸ enable us to have better practices on the management of the Covid-19 infection in pwMS.

OBJECTIVE

To investigate the incidence of coronavirus disease 2019 (Covid-19) and to reveal the relationship between the demographic-clinical and therapeutic features and the outcome of Covid-19 infection in a multi-center national cohort of pwMS.

METHODS

The Turkish Neurological Society-MS Study Group in association with the Italian MuSC-19 Study Group initiated this study. A web-based electronic Case Report Form (eCRF) of Study-MuSC-19 were used to collect the data. The demographic data and MS histories of the patients were obtained from the file tracking forms of the relevant clinics.

RESULTS

309 MS patients with confirmed Covid-19 infection were included in this study. Two hundred nineteen (219) were females (70.9%). The mean age was 36.9, ranging from 18 to 66, 194 of them (62.8%) were under 40. The clinical phenotype was relapsing-remitting in 277 (89.6%) and progressive in 32 (10.4%). Disease duration ranged from 0.2 years to 31.4 years. The median EDSS was 1.5, ranging from 0 to 8.5. The EDSS score was<= 1 in 134 (43%) of the patients. 91.6% of the patients were on a DMT, Fingolimod was the most frequently used drug (22.0%), followed by Interferon (20.1%). The comorbidity rate is 11.7%. We were not able to detect any significant association of DMTs with Covid-19 severity.

CONCLUSION

The Turkish MS-Covid-19 cohort had confirmed that pwMS are not at risk of having a more severe COVID-19 outcome irrespective of the DMT that they are treated. In addition, due to being a younger population with less comorbidities most had a mild disease further highlight that the only associated risk factors for having a moderate to severe COVID-19 course are similar with the general population such as having comorbid conditions and being older.

摘要

背景

新型冠状病毒 2019 年(Covid-19)大流行也影响到多发性硬化症(pwMS)患者。目前,关于感染对疾病的人口统计学和临床特征以及不同 DMT 治疗结果的累积信息,使我们能够更好地管理 pwMS 中的 Covid-19 感染。

目的

研究 2019 年冠状病毒病(Covid-19)的发病率,并揭示多中心全国 pwMS 患者人群的人口统计学-临床和治疗特征与 Covid-19 感染结局之间的关系。

方法

土耳其神经病学会-MS 研究组与意大利 MuSC-19 研究组合作开展了这项研究。使用在线电子病例报告表(eCRF)收集研究-MuSC-19 的数据。从相关诊所的文件跟踪表中获取患者的人口统计学数据和 MS 病史。

结果

本研究纳入了 309 例确诊的 Covid-19 感染 MS 患者。219 例(70.9%)为女性。平均年龄为 36.9 岁,年龄范围为 18-66 岁,其中 194 例(62.8%)年龄小于 40 岁。临床表型为复发缓解型 277 例(89.6%)和进行性型 32 例(10.4%)。疾病病程从 0.2 年到 31.4 年不等。EDSS 中位数为 1.5,范围为 0-8.5。134 例(43%)患者的 EDSS 评分<=1。91.6%的患者接受了 DMT,最常使用的药物是 fingolimod(22.0%),其次是干扰素(20.1%)。合并症发生率为 11.7%。我们未能发现 DMT 与 Covid-19 严重程度之间存在任何显著关联。

结论

土耳其 MS-Covid-19 队列证实,pwMS 感染新冠病毒后不会出现更严重的 COVID-19 结局,无论他们接受何种 DMT 治疗。此外,由于该人群为年轻人群,合并症较少,大多数患者病情较轻,这进一步表明,导致中度至重度 COVID-19 病程的唯一相关危险因素与普通人群相似,如合并症和年龄较大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/320f/8053402/b19d79724797/gr1_lrg.jpg

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