Immovilli Paolo, Morelli Nicola, Terracciano Chiara, Rota Eugenia, Marchesi Elena, Vollaro Stefano, De Mitri Paola, Zaino Domenica, Bazzurri Veronica, Guidetti Donata
Neurology Unit, Emergency Department, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy.
Radiology Unit, Radiology Department, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy.
Neurol Int. 2022 Apr 15;14(2):368-377. doi: 10.3390/neurolint14020030.
The COVID-19 pandemic poses an ongoing global challenge, and several risk factors make people with multiple sclerosis (pwMS) particularly susceptible to running a severe disease course. Although the literature does report numerous articles on the risk factors for severe COVID-19 and vaccination response in pwMS, there is a scarcity of reviews integrating both these aspects into strategies aimed at minimizing risks. The aim of this review is to describe the risk of vulnerable pwMS exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the issues related to the SARS-CoV-2 vaccine and to evidence possible future strategies in the clinical management of pwMS. The authors searched for papers on severe COVID-19 risk factors, SARS-CoV-2 vaccination and people with multiple sclerosis in support of this narrative literature review. We propose a multilevel strategy aimed at: the evaluation of risk factors for severe COVID-19 in people with multiple sclerosis, identifying the most appropriate vaccination schedule that is safe for people on disease-modifying drugs (DMDs) and a strict follow-up of high-risk people with multiple sclerosis to allow for the prompt administration of monoclonal antibodies to manage COVID-19 risks in this patient population.
新冠疫情构成了持续的全球挑战，多种风险因素使多发性硬化症患者（pwMS）尤其容易出现严重病程。尽管文献中确实报道了大量关于pwMS中重症新冠风险因素及疫苗接种反应的文章，但将这两个方面整合到旨在降低风险的策略中的综述却很匮乏。本综述的目的是描述易感染的pwMS暴露于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的风险、与SARS-CoV-2疫苗相关的问题，并为pwMS临床管理中可能的未来策略提供证据。作者检索了关于重症新冠风险因素、SARS-CoV-2疫苗接种及多发性硬化症患者的论文，以支持本叙述性文献综述。我们提出了一项多层次策略，旨在：评估多发性硬化症患者中重症新冠的风险因素，确定对疾病修正药物（DMDs）使用者安全的最合适疫苗接种计划，并对高危多发性硬化症患者进行严格随访，以便及时给予单克隆抗体来管理该患者群体中的新冠风险。
