Infección grave por COVID-19 en pacientes con esclerosis múltiple en la Argentina / Severity of COVID-19 in patients with multiple sclerosis in Argentina

Resumen Introducción: Existe poca información local sobre el riesgo de infección grave por COVID-19 en pacientes con esclerosis múltiple (EM) que reciben tratamiento modificador de la enfermedad (DMT). El objetivo del estudio fue evaluar el impacto de la enfermedad por COVID-19 (gravedad y letalidad) en pacientes con EM que reciben DMT. Métodos: El estudio se realizó sobre una cohorte prospectiva de pacientes con EM. Se incluyeron 111 con EM y diagnóstico confirmado de COVID-19 tratados con DMT, seguidos hasta la resolución del COVID-19. Resultados: Un total de seis (5.4%; IC 95%: 2-11.4%) desarrollaron COVID-19 grave definido como requerimiento de internación en terapia intensiva o muerte, y tres fallecieron (tasa de letalidad cruda del 2.7%; IC 95%: 1.1-4.3%). La tasa de letalidad ajustada por edad fue del 1.5% (IC 95%: 0.6-2.4%). El factor que se asoció independientemente con COVID-19 grave fue la edad (OR 1.1; IC 1.0-1.3; p < 0.05) con una tendencia en la Escala del Estado de Incapacidad Ampliada (EDSS) ≥ 6(OR 6.2; IC 0.6-56.4; p = 0.10). Conclusión: La letalidad por COVID-19 en pacientes con EM es baja y la gravedad se asoció significativamente con la edad y mostró una tendencia con EDSS ≥ 6.

Abstract Introduction: There is limited local information on the risk of severe COVID-19 infection in patients with multiple sclerosis (MS) who are receiving disease-modifying treatments (DMT). The aim of the study was to assess the impact of COVID-19 disease (severity and lethality) in MS patients receiving DMT. Methods: The study was performed on a prospective cohort with EM. We included 111 patients with MS and a confirmed di agnosis of COVID-19 treated with DMT and followed up until the resolution of COVID-19. Results: A total of six patients (5.4%; 95% CI: 2-11.4%) developed severe COVID-19 defined as requiring hospitalization in intensive care unit or death and three died (crude case fatality rate of 2.7%; 95% CI: 1.1-4.3%). The age-adjusted case fatality rate was 1.5% (95% CI: 0.6-2.4%). The factor that was independently associated with severe COVID-19 was age (OR 1.1; CI 1.0-1.3; p < 0.05) with a trend in the Expanded Disability Status Scale (EDSS) ≥ 6 (OR 6.2; CI 0.6-56.4; p = 0.10). Conclusion: The lethality due to COVID-19 in MS patients is low, and severity was significantly associated with age and showed a trend with EDSS ≥ 6.

Progress in the application of assessment scales associated with activities of daily living in the disease-modifying treatments of spinal muscular atrophy / 国际儿科学杂志

Spinal muscular atrophy(SMA) is a serious neuromuscular degenerative disease that severely impairs the quality of life for patients and entire families.The emergence of disease-modifying treatments such as nusinersen and risdiplam has gradually changed the natural course of SMA patients.It is particularly important to include the activities of daily living(ADL) ability reported by patients or caregivers in the comprehensive assessment of SMA patients.There are many ADL-related assessment tools, and studies have found that disease-modifying treatments can somewhat improve the ADL ability of SMA children.This article reviews the progress on the effect of disease-modifying treatments on ADL in SMA patients, which can provide a reference for exploring more comprehensive and effective assessment tools and treatment decision-making in subsequent clinical practice.