COVID-19'un Hastalık Modifiye Edici Tedavi Alan Multipl Sklerozlu Bireylerdeki Hastalık Aktivitesi, Progresyonu ve Bilişsel İşlev Bozukluğu Üzerine Etkisi
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COVID-19 (Koronavirüs Hastalığı-19) pandemisinin başlangıcından bu yana, Multipl Sklerozlu (MS) hastaların bu viral enfeksiyondan nasıl etkilenecekleri merak konusu olmuştur. COVID-19 enfeksiyonu ile ilişkili santral sinir sistemine ait demyelinizan olayların rapor edilmesi, hastalık modifiye edici tedavilerin (Disease-modifying therapies, DMT) bağışık yanıt üzerindeki etkilerinin COVID-19’un seyrini değiştirebileceğinin öne sürülmesi, klinik sonuçlar hakkında bilgi toplama ihtiyacını doğurmuştur. COVID-19 enfeksiyonu ile ilişkili olarak ortaya çıkan demiyelinizan olaylar ile enfeksiyonla ilişkili olmayan olaylar arasında atak şiddeti ve akut tedavilere yanıtla igili farklılıklar olup olmadığı konusundaki araştırmalar devam etmektedir. Bu çalışma COVID-19 enfeksiyonuna yakalanan, DMT almakta olan 30 MS’li hastada, COVID-19 enfeksiyonunun MS’in seyrine etkisini araştırmak amacıyla yapılmıştır. Ocak 2020-Ocak 2024 tarihleri arasında MS tanısı ile takipli olan 30 hasta, hastalığın progresyonu, nüksler, manyetik rezonans görüntüleme (MRG) bulgularındaki değişiklikler (beyin lezyonları) ve bilişsel (kognitif) etkilenme açısından 36 ay boyunca değerlendirildi. 30 hastanın 20'si kadın 10’u erkek hasta idi. Yaş aralığı 25-70 arasında değişmekteydi. Hastalık tipleri olarak 5 olgu Sekonder Progresif Multipl Skleroz (SPMS), 25 olgu Relapsing-Remitting Multipl Skleroz (RRMS) idi. DMT’ler 20 olguda Dimetil Fumarat, 10 olguda Fingolimod idi. SPMS’u olan hastalardan 2’sinde COVID-19 enfeksiyonu sonrasında şiddetli nüks (atak) görüldü. Bu hastalar fingolimod kullanmaktaydı. Tüm grup içinde 28 hastada; nüks, progresyon, MRG bulgularında değişiklik ve bilişsel işlevlerde bozulma görülmedi. Bu çalışmada COVID-19'un MS hastalığı üzerine olumsuz etkilerinin olduğunu gösteren bulgular saptanmadı.
Abstract (En)
Since the beginning of the COVID-19 (Coronavirüs Disease-19) pandemic, it has been a matter of curiosity how patients with Multiple Sclerosis (MS) will be affected by this viral infection. Reporting demyelinating events of the central nervous system associated with COVID-19 infection and suggesting that the effects of disease-modifying therapies (DMT) on the immune response may change the course of COVID-19 have created the need to collect information about clinical results. Research is ongoing to determine whether there are differences in attack severity and response to acute treatments between demyelinating events associated with COVID-19 infection and events not related to infection.This study was conducted to investigate the effect of COVID-19 infection on the course of MS in 30 patients with MS who were infected with COVID-19 and were receiving DMT. 30 patients who were followed up with a diagnosis of MS between January 2020 and January 2024 were evaluated for 36 months in terms of disease progression, relapses, changes in magnetic rezonans imaging (MRI) findings (brain lesions), and cognitive effects. Of the 30 patients, 20 were female and 10 were male. The age range varied between 25-70. As for the disease types, 5 cases were secondary progressive multiple sclerosis (SPMS) and 25 cases were Relapsing Remitting Multiple Sclerosis (RRMS). The disease-modifying therapies used were Dimethyl Fumarate in 20 cases and Fingolimod in 10 cases. Two of the patients with SPMS had a severe relapse after COVID-19 infection. These patients were using Fingolimod. In 28 patients in the whole group; there was no recurrence, progression, change in MRI findings or deterioration in cognitive functions. In this study, no findings were observed indicating that COVID-19 had negative effects on multiple sclerosis
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Additional details
Additional titles
- Translated title (En)
- The Effect of COVİD-19 on Disease Activity, Progression and Cognitive Dysfunction in Individuals with Multiple Sclerosis, Receiving Disease-Modifying Therapy
References
- Apostolos-Pereira, S. L., et al. (2021). Clinical features of COVID-19 on patients with neuromyelitis optica spectrum disorders. Neurol Neuroimmunol Neuroinflamm, 8, 1060. doi: https://doi.org/10.1212/NXI.0000000000001060 Arrambide, G., et al. (2021). SARS-CoV-2 infection in multiple sclerosis: Results of the Spanish Neurology Society Registry. Neurol Neuroimmunol Neuroinflamm, 8(5), e1024. doi: https://doi.org/10.1212/NXI.0000000000001024 Barzegar, M., et al. (2020). COVID-19 infection in a patient with multiple sclerosis treated with fingolimod. Neurol Neuroimmunol Neuroinflamm, 7, 753. doi: https://doi.org/10.1212/NXI.0000000000000753 Barzegar, M., et al. (2021). Can coronavirus disease 2019 (COVID-19) trigger exacerbation of multiple sclerosis? A retrospective study. Mult Scler Relat Disord, 52, 102947. doi: https://doi.org/10.1016/j.msard.2021.102947 Chyzhyk, V., et al. (2021). Is SARS-CoV-2 important for multiple sclerosis? Eur J Neurol, 2021, 492. doi: https://doi.org/10.1111/ene.14874 Conway, S., et al. (2021). COVID-19 and neurologic outcomes in multiple sclerosis and related disorders. Multiple Scler J, 2021, 765. doi: https://doi.org/10.1177/13524585211024128 Corrêa, D. G., et al. (2021). COVID-19 associated with encephalomyeloradiculitis and positive anti-aquaporin-4 antibodies. Mult Scler J, 27, 973–976. doi: https://doi.org/10.1177/1352458520949988 Czarnowska, A., et al. (2021). Symptoms after COVID-19 infection in individuals with multiple sclerosis in Poland. J Clin Med, 10, 225225. doi: https://doi.org/10.3390/jcm10225225 Das, D., et al. (2022). Neuromyelitis optica spectrum disorder post-COVID-19 infection. Indian J Ophthalmol, 70, 1833–1836. doi: https://doi.org/10.4103/ijo.IJO_61_22 Desforges, M., et al. (2019). Human coronaviruses and other respiratory viruses. Viruses, 12, 14. doi: https://doi.org/10.3390/v12010014 Dhillon, P. S., et al. (2021). Neurological disorders associated with COVID-19 hospital admissions. Front Neurol, 12, 640017. doi: https://doi.org/10.3389/fneur.2021.640017 Domingues, R. B., et al. (2020). First case of SARS-CoV-2 sequencing in CSF of a patient with suspected demyelinating disease. J Neurol, 267, 3154–3156. doi: https://doi.org/10.1007/s00415-020-09996-w Etemadifar, M., et al. (2021). COVID-19 and the risk of relapse in multiple sclerosis patients. Mult Scler Relat Disord, 51, 102915. doi: https://doi.org/10.1016/j.msard.2021.102915 Etemadifar, M., et al. (2022). Does COVID-19 increase the long-term RRMS clinical activity? BMC Neurol, 22, 64. doi: https://doi.org/10.1186/s12883-022-02590-9 Fragoso, Y. D., et al. (2021). COVID-19 in a temporal relation to the onset of multiple sclerosis. Mult Scler Relat Disord, 50, 102863. doi: https://doi.org/10.1016/j.msard.2021.102863 Gutiérrez-Ortiz, C., et al. (2020). Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology, 95, e601–e605. doi: https://doi.org/10.1212/WNL.0000000000009619 Huang, C., et al. (2020). Clinical features of patients infected with coronavirus in Wuhan. Lancet, 395, 497–506. doi: https://doi.org/10.1016/S0140-6736(20)30183-5 Ide, T., et al. (2022). SARS-CoV-2-related MOGAD. Intern Med, 2022, 21. doi: https://doi.org/10.2169/internalmedicine.8709-21 Jentzer, A., et al. (2022). Neuromyelitis optica spectrum disorder following COVID-19 infection. J Neurol, 269, 2850–2853. doi: https://doi.org/10.1007/s00415-022-10972-9 Jossy, A., et al. (2022). COVID-19-associated optic neuritis. Indian J Ophthalmol, 70, 310–316. doi: https://doi.org/10.4103/ijo.IJO_2235_21 Karsidag, S., et al. (2021). Demyelinating disease of CNS concurrent with COVID-19. Cureus, 13, e17297. doi: https://doi.org/10.7759/cureus.17297 Khedr, E. M., et al. (2021). Acute neurological manifestations among Egyptian COVID-19 patients. Neuroepidemiology, 55, 109–118. doi: https://doi.org/10.1159/000513647 Khurana, D., et al. (2021). COVID-19 in multiple sclerosis: Experience from North India. J Neurol Sci, 429, 118164. doi: https://doi.org/10.1016/j.jns.2021.118164 Kogure, C., et al. (2021). MOG-associated optic neuritis in COVID-19. Medicine, 100, e25865. doi: https://doi.org/10.1097/MD.0000000000025865 Louapre, C., et al. (2020). Clinical characteristics and outcomes in MS patients with COVID-19. JAMA Neurol, 77(9), 1079–1088. doi: https://doi.org/10.1001/jamaneurol.2020.2681 Luetic, G., et al. (2021). COVID-19 in Argentine teriflunomide-treated MS patients. Mult Scler Relat Disord, 53, 103049. doi: https://doi.org/10.1016/j.msard.2021.103049 Maghzi, A. H., et al. (2020). COVID-19 in teriflunomide-treated MS patients. J Neurol, 267, 2790–2796. doi: https://doi.org/10.1007/s00415-020-09944-8 Mantero, V., et al. (2021). COVID-19 in dimethyl fumarate-treated MS patients. J Neurol, 268, 2023–2025. doi: https://doi.org/10.1007/s00415-020-10015-1 Marrodan, M., et al. (2019). The role of infections in multiple sclerosis. Mult Scler, 25, 891–901. doi: https://doi.org/10.1177/1352458518823940 Michelena, G., et al. (2022). Can COVID-19 exacerbate MS symptoms? Mult Scler Relat Disord, 57, 103368. doi: https://doi.org/10.1016/j.msard.2021.103368 Moore, L., et al. (2021). First presentation of multiple sclerosis with concurrent COVID-19 infection. eNeurologicalSci, 22, 100299. doi: https://doi.org/10.1016/j.ensci.2020.100299 Moreno-Torres, I., et al. (2021). Risk and outcomes of COVID-19 in patients with multiple sclerosis. Eur J Neurol, 28(11), 3712–3721. doi: https://doi.org/10.1111/ene.15089 Moriguchi, T., et al. (2020). First case of meningitis/encephalitis associated with SARS-CoV-2. Int J Infect Dis, 94, 55–58. doi: https://doi.org/10.1016/j.ijid.2020.03.062 Möhn, N., et al. (2020). Mild COVID-19 despite teriflunomide and high-dose methylprednisolone. J Neurol, 267, 2803–2805. doi: https://doi.org/10.1007/s00415-020-09921-1 Naser Moghadasi, A., et al. (2021). The prevalence of COVID-19 infection in MS: A systematic review and meta-analysis. Neurol Sci, 42(8), 3093–3099. doi: https://doi.org/10.1007/s10072-021-05373-1 Oikonen, M., et al. (2011). Temporal relationship between viral infections and MS relapse. Mult Scler, 17, 672–680. doi: https://doi.org/10.1177/1352458510394397 Palao, M., et al. (2020). Multiple sclerosis following SARS-CoV-2 infection. Mult Scler Relat Disord, 45, 102377. doi: https://doi.org/10.1016/j.msard.2020.102377 Paterson, R. W., et al. (2020). Emerging spectrum of COVID-19 neurology. Brain, 143, 3104–3120. doi: https://doi.org/10.1093/brain/awaa240 Paybast, S., et al. (2022). One-year follow-up of MS patients during COVID-19 pandemic. Mult Scler Relat Disord, 60, 103712. doi: https://doi.org/10.1016/j.msard.2022.103712 Peters, J., et al. (2021). MOG-associated encephalitis following SARS-CoV-2. Mult Scler Relat Disord, 50, 102857. doi: https://doi.org/10.1016/j.msard.2021.102857 Pignolo, A., et al. (2021). Clinical onset and MS relapse after SARS-CoV-2 infection. Neurol Int, 13, 695–700. doi: https://doi.org/10.3390/neurolint13040066 Pinto, A. A., et al. (2020). CNS inflammatory vasculopathy with anti-MOG antibodies in COVID-19. Neurol Neuroimmunol Neuroinflamm, 7, 813. doi: https://doi.org/10.1212/NXI.0000000000000813 Qin, C., et al. (2020). Dysregulation of immune response in COVID-19. Clin Infect Dis, 71, 762–768. doi: https://doi.org/10.1093/cid/ciaa248 Ramagopalan, S. V., et al. (2009). Association of infectious mononucleosis with MS. Neuroepidemiology, 32, 257–262. doi: https://doi.org/10.1159/000201564 Reder, A. T., et al. (2021). COVID-19 in MS: Associations with DMTs. CNS Drugs, 35, 317–330. doi: https://doi.org/10.1007/s40263-021-00804-1 Salter, A., et al. (2021). Outcomes and risk factors associated with COVID-19 in MS. JAMA Neurol, 78(6), 699–708. doi: https://doi.org/10.1001/jamaneurol.2021.0687 Sandoval, F., et al. (2021). Neurologic features associated with SARS-CoV-2 in children. J Child Neurol, 36, 853–866. doi: https://doi.org/10.1177/0883073821989164 Simpson-Yap, S., et al. (2021). Associations of DMTs with COVID-19 severity. Neurology, 97, e1870–e1885. doi: https://doi.org/10.1212/WNL.0000000000012753 Sormani, M. P., et al. (2021). DMTs and COVID-19 severity in MS. Ann Neurol, 89, 780–789. doi: https://doi.org/10.1002/ana.26028 Thompson, A. J., et al. (2018). Diagnosis of multiple sclerosis: 2017 McDonald criteria. Lancet Neurol, 17, 162–173. doi: https://doi.org/10.1016/S1474-4422(17)30470-2 Verstrepen, K., et al. (2020). Neurological manifestations of COVID-19, SARS and MERS. Acta Neurol Belg, 120, 1051–1060. doi: https://doi.org/10.1007/s13760-020-01412-4 Vraka, K., et al. (2021). Encephalopathy in two pediatric patients with COVID-19. Case Rep Neurol Med, 2021, 6658000. doi: https://doi.org/10.1155/2021/6658000 Wildemann, B., et al. (2022). Severe MS exacerbation with Takotsubo cardiomyopathy during COVID-19. J Neurol, 269, 1138–1141. doi: https://doi.org/10.1007/s00415-021-10779-0 Winkelmann, A., et al. (2016). DMTs and infectious risks in MS. Nat Rev Neurol, 12(4), 217–233. doi: https://doi.org/10.1038/nrneurol.2016.36 Yavari, F., et al. (2020). Demyelinating changes alike to MS: Rare COVID-19 case. Case Rep Neurol Med, 2020, 6682251. doi: https://doi.org/10.1155/2020/6682251 Zhou, S., et al. (2020). Anti-MOG associated optic neuritis and myelitis in COVID-19. J Neuroophthalmol, 40, 398–402. doi: https://doi.org/10.1097/WNO.0000000000001049