多发性硬化症患者的 COVID-19 特征。
Characteristics of COVID-19 in patients with multiple sclerosis.
机构信息
Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
Mult Scler Relat Disord. 2022 Jan;57:103437. doi: 10.1016/j.msard.2021.103437. Epub 2021 Nov 30.
BACKGROUND
Regarding the high prevalence of multiple sclerosis (MS) and COVID-19 in Iran, a multicenter study of COVID-19 in Iranian MS patients with is carried out to address the concerns of this population.
METHODS
Data on MS patients with COVID-19 from nine provinces of Iran were entered in a web-based registry system, between July 2020 and March 2021. Among the COVID-19 symptoms, dyspnea, altered mental status, or those resulting in hospital admission were considered severe.
RESULTS
A total of 397 eligible patients were identified. In addition, 310 (78%) were female. The mean age was 36.5 ± 9.5. 294 (74%) patients had relapsing- remitting form. Also, four patients (1%) expired due to COVID-19 infection. The mean duration of admission in hospitalized patients was 9 (± 5.3) days. MRI was performed on 111 (28%) patients after developing COVID-19. MRI changes were observed in 27 (24%) of these cases. MS drug was changed in 26 (6%) patients. Steroid use in the past three months (OR: 2.43, 95% CI: 1.003-5.88) (p value: 0.049) and antiCD20s (OR: 4.03, 95% CI: 2.41-6.68) (p value < 0.001) showed significant association with severe COVID-19 symptoms.
CONCLUSION
The death rate of COVID-19 among MS patients (1%) is lower than the overall death rate of the pandemic in Iran (3%). Those who received steroid in the past three months may be at increased risk of more severe forms of COVID-19. There are still doubts about the effect of anti CD20s on COVID-19 severity.
背景
鉴于多发性硬化症（MS）在伊朗的高患病率和 COVID-19 的流行，对伊朗 MS 患者中的 COVID-19 进行了一项多中心研究，以解决该人群的担忧。
方法
2020 年 7 月至 2021 年 3 月期间，通过在线注册系统收集伊朗九个省份的 MS 合并 COVID-19 患者的数据。COVID-19 症状中，呼吸困难、精神状态改变或导致住院的症状被认为是严重的。
结果
共确定了 397 名符合条件的患者。此外，310 名（78%）为女性。平均年龄为 36.5 ± 9.5 岁。294 名（74%）患者为复发缓解型。另外，有 4 名患者（1%）因 COVID-19 感染而死亡。住院患者的平均住院时间为 9（± 5.3）天。111 名（28%）患者在发生 COVID-19 后进行了 MRI 检查。这些病例中有 27 例（24%）出现 MRI 改变。26 名（6%）患者改变了 MS 药物。过去三个月使用类固醇（OR：2.43，95%CI：1.003-5.88）（p 值：0.049）和抗 CD20s（OR：4.03，95%CI：2.41-6.68）（p 值<0.001）与 COVID-19 严重症状显著相关。
结论
MS 患者 COVID-19 死亡率（1%）低于伊朗大流行的总体死亡率（3%）。过去三个月内使用类固醇的患者可能有更高的风险出现更严重的 COVID-19 症状。关于抗 CD20s 对 COVID-19 严重程度的影响仍存在疑问。
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