Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies - the Polish experience

被引：31

作者：

Czarnowska, Agata ^{[1
]}

Brola, Waldemar ^{[2
]}

Zajkowska, Olga ^{[3
]}

Rusek, Stanislaw ^{[4
]}

Adamczyk-Sowa, Monika ^{[5
]}

Kubicka-Baczyk, Katarzyna ^{[5
]}

Kalinowska-Lyszczarz, Alicja ^{[6
]}

Kania, Karolina ^{[7
]}

Slowik, Agnieszka ^{[8
]}

Wnuk, Marcin ^{[8
]}

Marona, Monika ^{[8
]}

Podlecka-Pietowska, Aleksandra ^{[9
]}

Nojszewska, Monika ^{[9
]}

Zakrzewska-Pniewska, Beata ^{[9
]}

Jasinska, Elzbieta ^{[2
,10
]}

Goluch, Katarzyna ^{[10
]}

Lech, Beata ^{[11
]}

Noga, Magdalena ^{[11
]}

Perenc, Adam ^{[11
]}

Popiel, Malgorzata ^{[11
]}

Lasek-Bal, Anetta ^{[12
]}

Puz, Przemyslaw ^{[12
]}

Maciejowska, Katarzyna ^{[12
]}

Kucharska-Lipowska, Marta ^{[13
]}

Lipowski, Michal ^{[14
]}

Kapica-Topczewska, Katarzyna ^{[1
]}

Chorazy, Monika ^{[1
]}

Tarasiuk, Joanna ^{[1
]}

Kochanowicz, Jan ^{[1
]}

Kulikowska, Joanna ^{[1
]}

Wawrzyniak, Slawomir ^{[15
]}

Niezgodzinska-Maciejek, Anna ^{[15
]}

Pokryszko-Dragan, Anna ^{[16
]}

Gruszka, Ewa ^{[16
]}

Budrewicz, Slawomir ^{[16
]}

Bialek, Marta ^{[17
]}

Kurkowska-Jastrzebska, Iwona ^{[18
]}

Kurowska, Katarzyna ^{[18
]}

Stepien, Adam ^{[19
]}

Wlodek, Agata ^{[20
]}

Ptasznik, Violetta ^{[21
]}

Pawelczyk, Malgorzata ^{[22
]}

Sobolewski, Piotr ^{[23
,24
]}

Lejmel, Henryka ^{[25
]}

Strzalinska, Katarzyna ^{[26
]}

Maciejowski, Maciej ^{[27
]}

Tutaj, Andrzej ^{[28
]}

Zwiernik, Jacek ^{[28
,29
]}

Litwin, Anna ^{[28
]}

Lewanczyk, Bozena ^{[30
]}

机构：

[1] Med Univ Bialystok, Dept Neurol, M Sklodowskiej Curie 24A Str, PL-15276 Bialystok, Poland

[2] Jan Kochanowski Univ, Coll Med, Kielce, Poland

[3] Univ Warsaw, Fac Econ Sci, Warsaw, Poland

[4] Specialist Hosp Ludwika Rydygiera Krakow, Dept Neurol, Krakow, Poland

[5] Med Univ Silesia, Fac Med Sci Zabrze, Dept Neurol, Katowice, Poland

[6] Poznan Univ Med Sci, Dept Neurol, Div Neurochem & Neuropathol, Poznan, Poland

[7] Poznan Univ Med Sci, Dept Neurol, Poznan, Poland

[8] Jagiellonian Univ, Dept Neurol, Med Coll, Krakow, Poland

[9] Med Univ Warsaw, Dept Neurol, Warsaw, Poland

[10] Clin Ctr, Resmed, Kielce, Poland

[11] Clin Hosp 2, Neurol Clin, Brain Stroke Sub Unit, Rzeszow, Poland

[12] Med Univ Silesia, Sch Hlth Sci, Dept Neurol, Katowice, Poland

[13] Specialist Hosp Konskie, Dept Neurol, Konskie, Poland

[14] Specialist Hosp Konskie, Dept Urol, Konskie, Poland

[15] 10th Mil Res Hosp & Polyclin, Independent Publ Healthcare Ctr, Dept Neurol, Bydgoszcz, Poland

[16] Wroclaw Med Univ, Dept Neurol, Wroclaw, Poland

[17] Reg Specialised Hosp 4 Bytom, Dept Neurol, Bytom, Poland

[18] Inst Psychiat & Neurol, Dept Neurol 2, Warsaw, Poland

[19] Mil Inst Med, Dept Neurol, Warsaw, Poland

[20] Masovian Voivodeship Hosp Siedlce, Dept Neurol, Siedlce, Poland

[21] Specialist Hosp Pila, Dept Neurol, Pila, Poland

[22] Med Univ Lodz, Dept Neurol & Stroke, Lodz, Poland

[23] Jan Kochanowski Univ Kielce, Coll Med, Dept Neurol, Kielce, Poland

[24] Jan Kochanowski Univ Kielce, Coll Med, Stroke Unit Sandomierz, Kielce, Poland

[25] Reg Hosp Suwalki, Dept Neurol, Suwalki, Poland

[26] Reg Hosp Lomza, Dept Neurol, Lomza, Poland

[27] MS Ctr, KMK Clin, Katowice, Poland

[28] Prov Specialist Hosp, Neurol Ward, Olsztyn, Poland

[29] Univ Warmia & Mazury, Dept Neurol, Olsztyn, Poland

[30] Prov Integrated Hosp, Neurol Ward, Elblag, Poland

[31] Univ Warmia & Mazury, Fac Med, Dept Pharmacol & Toxicol, Olsztyn, Poland

[32] Specialist Hosp Dr Tytus Chalubinski, Dept Neurol, Radom, Poland

[33] Reg Hosp Skarzysko Kamienna, Dept Neurol, Skarzysko Kamienna, Poland

[34] Rzeszow Univ, Inst Med Sci, Dept Neurol, Med Coll, Rzeszow, Poland

来源：

NEUROLOGIA I NEUROCHIRURGIA POLSKA | 2021年 / 55卷 / 02期

关键词：

multiple sclerosis; COVID-19; SARS-CoV-2; disease-modifying therapies;

D O I：

10.5603/PJNNS.a2021.0031

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background. The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited. Materials and methods. This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health. Results. There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used. Conclusions and clinical implications. Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.

引用

页码：212 / 222

页数：11

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