Morawiec Natalia, Adamczyk Bożena, Adamczyk-Sowa Monika
Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
Neurol Neurochir Pol. 2023;57(1):77-89. doi: 10.5603/PJNNS.a2023.0008. Epub 2023 Feb 17.
Due to a similar pathomechanism, COVID-19 infection may significantly affect the course of autoimmune diseases (AIDs). In our review, we aimed to assess the severity of SARS-CoV-2 infection, response to treatment, and the impact of COVID-19 infection on the course of the underlying disease in patients with neuroimmune diseases.
In the time of the COVID-19 pandemic, it was important to determine the influence of COVID-19 infection on the course of autoimmune diseases due to the weakened immune system and immunosuppressive therapies.
Many reports have indicated that in patients with AIDs, the existence of the disease is not associated with a worse prognosis in the course of the viral infection. Patients in advanced stages of the disease, elderly patients, and those with comorbidities are at risk of more frequent hospitalisations and higher mortality in the course of COVID-19. Moreover, some drugs used in AIDs have been tested for their efficacy in SARS-CoV-2 infection. Episodes of newly diagnosed myasthenia gravis, Guillain-Barré syndrome, acute disseminated encephalomyelitis (ADEM), and neuromyelitis optica spectrum disorder (NMOSD) secondary to COVID-19 or vaccination have also been reported. Vaccination against this pathogen is highly recommended in most patients with AIDs.
Despite many studies on the association between COVID-19 and neuroimmune diseases, more specific data is needed. The approach to patients with AIDs should be individual, since many issues remain unresolved despite the long-lasting pandemic.
由于发病机制相似，新型冠状病毒肺炎（COVID-19）感染可能会显著影响自身免疫性疾病（AIDs）的病程。在我们的综述中，我们旨在评估感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的严重程度、对治疗的反应以及COVID-19感染对神经免疫疾病患者基础疾病病程的影响。
在COVID-19大流行期间，由于免疫系统减弱和免疫抑制治疗，确定COVID-19感染对自身免疫性疾病病程的影响非常重要。
许多报告表明，在患有AIDs的患者中，疾病的存在与病毒感染病程中较差的预后无关。处于疾病晚期的患者、老年患者以及合并症患者在COVID-19病程中住院频率更高且死亡率更高。此外，一些用于治疗AIDs的药物已在SARS-CoV-2感染中进行了疗效测试。也有报告称出现了继发于COVID-19或疫苗接种的新诊断重症肌无力、吉兰-巴雷综合征、急性播散性脑脊髓炎（ADEM）和视神经脊髓炎谱系障碍（NMOSD）病例。大多数AIDs患者强烈建议接种针对该病原体的疫苗。
尽管对COVID-19与神经免疫疾病之间的关联进行了许多研究，但仍需要更具体的数据。对AIDs患者的治疗应因人而异，因为尽管长期流行，但许多问题仍未得到解决。
