Neurology Section, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Al Rawdah Road, P. O. Box: 40047, Jeddah 21499, Saudi Arabia.
Neurology Section, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Al Rawdah Road, P. O. Box: 40047, Jeddah 21499, Saudi Arabia.
Mult Scler Relat Disord. 2022 Sep;65:103985. doi: 10.1016/j.msard.2022.103985. Epub 2022 Jun 20.
COVID-19 pandemic is thought to influence the natural history of immune disorders, yet the knowledge on its effect on multiple sclerosis (MS) is unknown and not fully understood for which we conducted this retrospective study.
We included all patients with MS seen in King Faisal Specialist Hospital and Research Centre in Jeddah, Saudi Arabia, between January 2017 and October 20201. We determined clinical and radiological evidence of disease activities in all patients by the end of the study period, and we compared the disease patterns before and during the pandemic. We also identified patients with COVID-19 since March 2020, who had at least 3 months of follow-up following the infection.
We studied 301 patients; 216 (72%) were women, the mean age was 38 years (range; 16, 73 years), the mean disease duration was 10 years (range; 1, 36 years), and the median EDSS score was 0.5 (range; 0, 8). RRMS accounted for most of the cases (270 patients). MS disease activities were 25% less prevalent during the pandemic compared to the preceding 3 years (26 vs. 51%, respectively, p < 0.01). Bivariate analysis showed significant higher disease activities in patients younger than 35 years (73 vs 27%), on DMT (68 vs 32%), and complaint to therapy (69 vs 31%). Multiple logistic regression analysis showed that the likelihood of MS disease activities were 3 times more during the pre-pandemic era (adjusted OR = 3.1, p value < 0.05, 95% CI; 1.4, 7.1). Thirty patients (10%) were infected with COVID-19. All patients reported mild symptoms, and none required hospitalization. COVID-19 was prevalent among younger patients with RRMS, with low EDSS scores, irrespective of DMTs they received. COVID-19 infection was not associated with clinical relapses or MRI changes. Disease activities were dependent on DMT use and not COVID-19 status. Multivariate analyses also confirmed no effect of COVID-19 on disease activities (p = 0.3 and 0.4, for clinical and MRI changes, respectively).
MS disease activities did not increase during the pandemic, yet the apparent decrease in the disease activities is probably due to under reporting and not a real decrease in disease activities because of the pandemic. The COVID-19 infection in our MS patients showed a benign disease course, yet standard precautions to reduce the risk of COVID-19 transmission should be applied accordingly.
COVID-19 大流行被认为会影响免疫紊乱的自然病史，但目前尚不清楚其对多发性硬化症（MS）的影响，我们进行了这项回顾性研究。
我们纳入了 2017 年 1 月至 2020 年 10 月在沙特阿拉伯吉达的法伊萨尔国王专科医院和研究中心就诊的所有 MS 患者。我们在研究结束时确定了所有患者的临床和放射学疾病活动证据，并比较了大流行前后的疾病模式。我们还确定了自 2020 年 3 月以来感染 COVID-19 的患者，这些患者在感染后至少有 3 个月的随访。
我们研究了 301 名患者；216 名（72%）为女性，平均年龄为 38 岁（范围：16-73 岁），平均病程为 10 年（范围：1-36 年），平均 EDSS 评分为 0.5（范围：0-8）。RRMS 占大多数病例（270 例）。与前 3 年相比，大流行期间 MS 疾病活动的发生率低 25%（分别为 26%和 51%，p<0.01）。双变量分析显示，35 岁以下患者（73%比 27%）、使用 DMT（68%比 32%）和对治疗有抱怨（69%比 31%）的疾病活动明显更高。多变量逻辑回归分析显示，大流行前时期 MS 疾病活动的可能性增加了 3 倍（调整后的 OR=3.1，p 值<0.05，95%CI：1.4，7.1）。30 名患者（10%）感染了 COVID-19。所有患者均报告有轻度症状，且无需住院治疗。COVID-19 在年轻的 RRMS 患者中更为普遍，这些患者的 EDSS 评分较低，与他们接受的 DMT 无关。COVID-19 感染与临床复发或 MRI 变化无关。疾病活动取决于 DMT 的使用，而与 COVID-19 状态无关。多变量分析也证实 COVID-19 对疾病活动没有影响（临床和 MRI 变化的 p 值分别为 0.3 和 0.4）。
MS 疾病活动在大流行期间并未增加，但疾病活动的明显减少可能是由于报告不足，而不是由于大流行导致疾病活动真正减少。我们的 MS 患者的 COVID-19 感染表现出良性疾病过程，但应采取标准预防措施以降低 COVID-19 传播的风险。
