Prosperini Luca, Arrambide Georgina, Celius Elisabeth G, Goletti Delia, Killestein Joep, Kos Daphne, Lavorgna Luigi, Louapre Celine, Sormani Maria Pia, Stastna Dominika, Ziemssen Tjalf, Di Filippo Massimiliano
MS Centre, Department of Neurosciences, S. Camillo-Forlanini Hospital, Rome, Italy.
Neurology-Neuroimmunology Department Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.
Lancet Reg Health Eur. 2024 Aug 22;44:100979. doi: 10.1016/j.lanepe.2024.100979. eCollection 2024 Sep.
During the COVID-19 pandemic, people with multiple sclerosis (MS) and their healthcare providers have faced unique challenges related to the interaction between SARS-CoV-2, underlying neurological disease and the use of disease-modifying treatments (DMTs). Key concerns arose, primarily related to the possibility that SARS-CoV-2 infection could trigger the initial demyelinating event or exacerbate disease activity. Another major concern was the safety and efficacy of the COVID-19 vaccines, especially for patients undergoing specific treatments that could weaken their antibody responses. In the post-infection phase, identifying long COVID in patients with MS has been complicated due to the large overlap between post-infection sequelae and MS symptoms. In addition, disruptions in health and rehabilitation services have made it difficult for MS patients to access care. This Series article explores current evidence on the interaction between MS and SARS-CoV-2, identifies the challenges posed by the COVID-19 pandemic in the care of patients with MS, and discusses the significant adoption of digital health solutions, including telemedicine and new technology-based rehabilitation approaches. Based on lessons learned, recommendations and future directions are offered for managing patients with MS, rethinking healthcare systems and improving health outcomes in the post-COVID-19 pandemic era.
在新冠疫情期间，多发性硬化症（MS）患者及其医疗服务提供者面临着与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）、潜在神经疾病以及疾病修正治疗（DMTs）的使用之间相互作用相关的独特挑战。主要出现了一些关键问题，主要涉及SARS-CoV-2感染可能引发初始脱髓鞘事件或加剧疾病活动的可能性。另一个主要问题是新冠疫苗的安全性和有效性，尤其是对于正在接受可能削弱其抗体反应的特定治疗的患者。在感染后阶段，由于感染后后遗症与MS症状有很大重叠，在MS患者中识别长期新冠变得很复杂。此外，健康和康复服务的中断使MS患者难以获得护理。本系列文章探讨了关于MS与SARS-CoV-2之间相互作用的现有证据，确定了新冠疫情在MS患者护理中带来的挑战，并讨论了数字健康解决方案的大量采用情况，包括远程医疗和基于新技术的康复方法。基于所吸取的经验教训，为在新冠疫情后时代管理MS患者、重新思考医疗系统以及改善健康结果提供了建议和未来方向。
