COVID-19 严重程度与多发性硬化症和相关疾病的神经功能恶化结局相关。
COVID-19 severity is associated with worsened neurological outcomes in multiple sclerosis and related disorders.
机构信息
Brigham Multiple Sclerosis Center, Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Biostatistics Center, Brigham Multiple Sclerosis Center, Harvard Medical School, Brigham and Women's Hospital, Boston, USA.
出版信息
Mult Scler Relat Disord. 2022 Jul;63:103946. doi: 10.1016/j.msard.2022.103946. Epub 2022 Jun 6.
BACKGROUND
Neurologic outcomes in patients with multiple sclerosis (MS) and related disorders (MSRD) following COVID-19 is not well understood. The objective of this study was to investigate neurologic outcomes in patients with MSRD post-COVID-19.
METHODS
This was a retrospective medical records review study of adult patients with MSRD and COVID-19 infection at the Brigham MS Center. Neurologic worsening post-COVID-19 was defined as having a relapse, pseudorelapse, new brain MRI activity, worsening of preexisting MSRD symptoms, or development of other long-term neurologic symptoms.
RESULTS
111 patients, 85 (76.6%) females, with a mean [SD] age of 49.3 [12.2] years and median [range] EDSS of 2.5 [0, 8.5] were identified. 41 patients (36.9%) had neurologic worsening post-COVID-19. Of those, 19 (46.3%) had pseudorelapses, 2 (4.8%) had relapses, and 24 (58.5%) patients reported worsening of preexisting MSRD symptoms, or other new long-term neurologic symptoms. Neurologic worsening was associated with hospitalized (moderate or severe) COVID-19 (p = 0.001), treatment for COVID-19 (p = 0.006), and incomplete COVID-19 recovery (p = 0.0267) but not with age, sex, MS type, race, disease duration, EDSS, vitamin D use, or disease modifying therapy use.
CONCLUSIONS
COVID-19 severity and lack of complete systemic recovery were associated with new or worsening neurologic symptoms in 36.9% of MSRD patients.
背景
新冠病毒（COVID-19）流行后，多发性硬化症（MS）及相关疾病（MSRD）患者的神经学结局尚不清楚。本研究旨在探讨 MSRD 患者 COVID-19 后的神经学结局。
方法
这是一项回顾性病历研究，纳入在布莱根 MS 中心就诊的 MSRD 合并 COVID-19 感染的成年患者。COVID-19 后神经学恶化定义为复发、假复发、新的脑 MRI 活动、原有 MSRD 症状恶化或出现其他长期神经学症状。
结果
共纳入 111 例患者，其中 85 例（76.6%）为女性，平均年龄为 49.3±12.2 岁，EDSS 中位数[范围]为 2.5[0，8.5]。41 例（36.9%）患者 COVID-19 后出现神经学恶化。其中，19 例（46.3%）为假复发，2 例（4.8%）为复发，24 例（58.5%）患者报告原有 MSRD 症状恶化或出现其他新的长期神经学症状。神经学恶化与住院（中重度）COVID-19（p=0.001）、COVID-19 治疗（p=0.006）和 COVID-19 未完全康复（p=0.0267）相关，与年龄、性别、MS 类型、种族、病程、EDSS、维生素 D 使用和疾病修正治疗使用无关。
结论
COVID-19 严重程度和缺乏完全的全身康复与 36.9%的 MSRD 患者新出现或恶化的神经学症状相关。
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