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轻链和转甲状腺素蛋白淀粉样变性患者医疗服务可及性受限的影响:法国新冠疫情封锁期间的真实世界调查

The impact of limited healthcare access among patients with light chain and transthyretin amyloidosis: real-world survey during COVID-19 lockdown period in France.

作者信息

Guijarro D, Jobbe-Duval A, Aguilhon S, Bauer F, Donal E, Eicher J C, Jeanneteau J, Gellen B, Kenizou D, Lairez O, Lequeux B, Legallois D, Réant P, Salvat M, Seronde M F, Kharoubi M, Whereat A, Farrugia A, Taieb C, Zaroui A, Damy T

机构信息

Cardiovascular Institute, Groupe Hospitalier Mutualiste de Grenoble, Grenoble, France.

Heart Failure Service, Assistance and Transplantation, Hospital Louis Pradel, Bron, France.

出版信息

Orphanet J Rare Dis. 2025 Jul 8;20(1):347. doi: 10.1186/s13023-025-03859-1.

Abstract

BACKGROUND

The containment strategies during the COVID-19 pandemic between December 2019 and 2022 significantly disrupted the healthcare system. Cardiac amyloidosis has a poor prognosis and requires frequent follow-up in reference centres.

OBJECTIVES

To assess the impact of limited access to healthcare on the patient burden and care pathway in France.

METHOD

This cross-sectional, self-questionnaire survey was conducted between June and October 2021 among cardiac amyloidosis patients registered at Expert Centres of the French Amyloidosis Network.

RESULTS

Overall, 1015 patients participated of whom, 229 had light chain amyloidosis, 786 had transthyretin amyloidosis. Disrupted clinical follow-up was reported in 21.1% of respondents, 15% had follow-up visits postponed. No alternative follow-up option was proposed for 45% of these patients. Few patients reported treatment discontinuation (Light chain (1.1%), transthyretin (1.3%). Significantly more newly diagnosed light chain (37.9%) than transthyretin amyloidosis patients (30.4%) reported the containment strategies caused a poor initial work-up experience (p = 0.034). Among those patients who reported a COVID19 infection (9.7%) more patients with light chain amyloidosis (75.0%) were hospitalized than transthyretin amyloidosis (37.1%), (p = 0.006). Only 587 (57.0%) patients answered vaccination question, most (92.0%) reported having been vaccinated.

CONCLUSION

Patients with light chain amyloidosis reported having had a higher impact to their care management than transthyretin amyloidosis patients during the COVID19 pandemic containment periods.

摘要

背景

2019年12月至2022年新冠疫情期间的防控策略严重扰乱了医疗系统。心脏淀粉样变性预后不良,需要在参考中心进行频繁随访。

目的

评估法国医疗服务受限对患者负担及治疗路径的影响。

方法

2021年6月至10月,对法国淀粉样变性网络专家中心登记的心脏淀粉样变性患者进行了这项横断面自填式问卷调查。

结果

共有1015名患者参与,其中229例为轻链淀粉样变性,786例为转甲状腺素蛋白淀粉样变性。21.1%的受访者报告临床随访中断,15%的患者随访就诊被推迟。其中45%的患者未得到替代随访方案。很少有患者报告治疗中断(轻链型1.1%,转甲状腺素蛋白型1.3%)。新诊断的轻链淀粉样变性患者(37.9%)比转甲状腺素蛋白淀粉样变性患者(30.4%)更频繁地报告防控策略导致初始检查体验不佳(p = 0.034)。在报告感染新冠病毒的患者中(9.7%),轻链淀粉样变性患者住院率(75.0%)高于转甲状腺素蛋白淀粉样变性患者(37.1%),(p = 0.006)。只有587名(57.0%)患者回答了疫苗接种问题,大多数(92.0%)报告已接种疫苗。

结论

在新冠疫情防控期间,轻链淀粉样变性患者报告其治疗管理受到的影响比转甲状腺素蛋白淀粉样变性患者更大。

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