From the Mental Health and Clinical Neurosciences Academic Unit, School of Medicine (A.G., N.E.), University of Nottingham; Clinical Neurology (A.G., N.E.), Nottingham University Hospitals NHS Trust; Population Data Science (R.M.M.), Swansea University Medical School; and Department of Cellular and Molecular Neuroscience (R.N.), Imperial College London, United Kingdom.
Neurol Neuroimmunol Neuroinflamm. 2021 Nov 30;9(1). doi: 10.1212/NXI.0000000000001118. Print 2022 Jan.
To understand the course of recovery from coronavirus disease 2019 (COVID-19) among patients with multiple sclerosis (MS) and to determine its predictors, including patients' pre-COVID-19 physical and mental health status.
This prospective and longitudinal cohort study recruited patients with MS who reported COVID-19 from March 17, 2020, to March 19, 2021, as part of the United Kingdom MS Register (UKMSR) COVID-19 study. Participants used online questionnaires to regularly update their COVID-19 symptoms, recovery status, and duration of symptoms for those who fully recovered. Questionnaires were date stamped for estimation of COVID-19 symptom duration for those who had not recovered at their last follow-up. The UKMSR holds demographic and up-to-date clinical data on participants as well as their web-based Expanded Disability Status Scale (web-EDSS) and Hospital Anxiety and Depression Scale (HADS) scores. The association between these factors and recovery from COVID-19 was assessed using multivariable Cox regression analysis.
Of the 7,977 patients with MS who participated in the UKMSR COVID-19 study, 599 reported COVID-19 and prospectively updated their recovery status. Twenty-eight hospitalized participants were excluded. At least 165 participants (29.7%) had long-standing COVID-19 symptoms for ≥4 weeks and 69 (12.4%) for ≥12 weeks. Participants with pre-COVID-19 web-EDSS scores ≥7, participants with probable anxiety and/or depression (HADS scores ≥11) before COVID-19 onset, and women were less likely to report recovery from COVID-19.
Patients with MS are affected by postacute sequelae of COVID-19. Preexisting severe neurologic impairment or mental health problems appear to increase this risk. These findings can have implications in tailoring their post-COVID-19 rehabilitation.
了解多发性硬化症（MS）患者从 COVID-19 中恢复的过程，并确定其预测因素，包括患者 COVID-19 之前的身心健康状况。
这项前瞻性和纵向队列研究招募了 2020 年 3 月 17 日至 2021 年 3 月 19 日期间报告 COVID-19 的 MS 患者，作为英国 MS 登记处（UKMSR）COVID-19 研究的一部分。参与者使用在线问卷定期更新他们的 COVID-19 症状、恢复状态和完全康复者的症状持续时间。对于那些在最后一次随访时尚未康复的患者，通过对问卷进行日期标记来估计 COVID-19 症状持续时间。UKMSR 拥有参与者的人口统计学和最新临床数据，以及他们的基于网络的扩展残疾状态量表（web-EDSS）和医院焦虑和抑郁量表（HADS）评分。使用多变量 Cox 回归分析评估这些因素与 COVID-19 恢复之间的关联。
在参加 UKMSR COVID-19 研究的 7977 名 MS 患者中，有 599 名报告 COVID-19 并前瞻性地更新了他们的恢复状态。排除了 28 名住院患者。至少有 165 名参与者（29.7%）出现持续至少 4 周的长期 COVID-19 症状，69 名参与者（12.4%）出现持续至少 12 周的长期 COVID-19 症状。COVID-19 发病前 web-EDSS 评分≥7 的参与者、有疑似焦虑和/或抑郁（HADS 评分≥11）的参与者以及女性报告 COVID-19 康复的可能性较小。
MS 患者受到 COVID-19 后急性期后遗症的影响。先前存在的严重神经功能障碍或心理健康问题似乎会增加这种风险。这些发现可能对定制他们的 COVID-19 后康复具有重要意义。
