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

Autor:	Czarnowska A; Medical University of Białystok, Poland. agata.czarnowska@umb.edu.pl., Brola W; Collegium Medicum, Jan Kochanowski University, Kielce, Poland., Zajkowska O; Faculty of Economic Sciences, University of Warsaw, Poland., Rusek S; Department of Neurology, Specialist Hospital Ludwika Rydygiera in Krakow, Poland., Adamczyk-Sowa M; Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland., Kubicka-Bączyk K; Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland., Kalinowska-Łyszczarz A; Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland., Kania K; Department of Neurology, Poznan University of Medical Sciences, Poland., Słowik A; Department of Neurology, Jagiellonian University Medical College, Krakow, Poland., Wnuk M; Department of Neurology, Jagiellonian University Medical College, Krakow, Poland., Marona M; Department of Neurology, Jagiellonian University Medical College, Krakow, Poland., Podlecka-Piętowska A; Department of Neurology, Medical University of Warsaw, Poland., Nojszewska M; Department of Neurology, Medical University of Warsaw, Poland., Zakrzewska-Pniewska B; Department of Neurology, Medical University of Warsaw, Poland., Jasińska E; Collegium Medicum UJK, and Clinical Center, RESMEDICA, Kielce, Poland., Gołuch K; Clinical Center, RESMEDICA, Kielce, Poland., Lech B; Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland., Noga M; Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland., Perenc A; Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland., Popiel M; Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland., Lasek-Bal A; Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland., Puz P; Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland., Maciejowska K; Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland., Kucharska-Lipowska M; Department of Neurology, Specialist Hospital in Końskie, Poland., Lipowski M; Department of Urology, Specialist Hospital in Końskie, Poland., Kapica-Topczewska K; Medical University of Białystok, Poland., Chorąży M; Medical University of Białystok, Poland., Tarasiuk J; Medical University of Białystok, Poland., Kochanowicz J; Medical University of Białystok, Poland., Kulikowska J; Medical University of Białystok, Poland., Wawrzyniak S; Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, Bydgoszcz, Poland., Niezgodzińska-Maciejek A; Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, Bydgoszcz, Poland., Pokryszko-Dragan A; Department of Neurology, Wroclaw Medical University, Wroclaw, Poland., Gruszka E; Department of Neurology, Wroclaw Medical University, Wroclaw, Poland., Budrewicz S; Department of Neurology, Wroclaw Medical University, Wroclaw, Poland., Białek M; Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Poland., Kurkowska-Jastrzębska I; 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland., Kurowska K; 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland., Stępień A; Department of Neurology, Military Institute of Medicine, Warsaw, Poland., Włodek A; Department of Neurology, Masovian Voivodeship Hospital in Siedlce, Poland., Ptasznik V; Department of Neurology, Specialist Hospital in Pila, Poland., Pawełczyk M; Department of Neurology and Stroke, Medical University of Lodz, Poland., Sobolewski P; Department of Neurology and Stroke Unit in Sandomierz, Collegium Medicum, Jan Kochanowski University in Kielce., Lejmel H; Department of Neurology, The Regional Hospital in Suwalki, Poland., Strzalińska K; Department of Neurology, The Regional Hospital in Łomża, Poland., Maciejowski M; KMK Clinical, MS Center, Katowice, Poland., Tutaj A; Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland., Zwiernik J; Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland; Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland., Litwin A; Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland., Lewańczyk B; Neurology Ward, Provincial Integrated Hospital, Elbląg, Poland., Paprocka I; Neurology Ward, Provincial Integrated Hospital, Elbląg, Poland., Zwiernik B; Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland; Clinic of Neurology, University of Warmia and Mazury, Olsztyn, Poland., Pawlos A; Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland., Borysowicz A; Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland., Narożnik A; Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland., Michałowska A; Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland., Nosek K; Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland., Fudala M; Department of Neurology, Regional Hospital in Skarżysko-Kamienna, Poland., Milewska-Jędrzejczak M; Department of Neurology and Ischemic Strokes, Medical University of Lodz, Poland., Kułakowska A; Medical University of Białystok, Poland., Bartosik-Psujek H; Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Poland.
Jazyk:	angličtina
Zdroj:	Neurologia i neurochirurgia polska [Neurol Neurochir Pol] 2021; Vol. 55 (2), pp. 212-222. Date of Electronic Publication: 2021 Apr 15.
DOI:	10.5603/PJNNS.a2021.0031
Abstrakt:	Introduction: 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.
Databáze:	MEDLINE
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