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Introduction: The role of ongoing disease-modifying therapy (DMT) in coronavirus disease 2019 (Covid-19) morbidity and mortality in people with multiple sclerosis (MS, pwMS) is uncertain. The MS International Federation recommends that pwMS continue their medication. Objective(s): To investigate the relationship between DMT used in MS patients and the risk of Covid-19 infection. Aim(s): The MS cohort of 3402 people followed for Covid-19 infection was included in this longitudinal cohort study. The whole MS cohort was interviewed at least once for information about Covid- 19, by text message, or by phone, during which 487 pwMS were determined with Covid-19 infection. A semi-structured interview, which included questions related to COVID-19 symptoms, recovery status, and duration of symptoms, was developed and performed by a team consisting medical doctor, nurse, and physiotherapist. Clinical information was obtained from the patient's medical records. Result(s): Of the 487 pwMS infected with Covid-19, 35 reported reinfections. The clinical and demographic profiles of participants were following: the mean age was 40.3+/-11.4, the mean disease duration was 10.7+/-8.2, the mean EDSS score was 1.7+/-2, 342 (70.2%) were female, 425 (87.3%) had relapsing-remitting MS, and 324 (6.5%) were working. The major differences regarding DMT between pwMS with and without Covid-19 infection were observed for fingolimod, ocrelizumab, and azathioprine. Fortythree (8.9%) people experienced the Covid-19 infection severely or critically;of those, 15 (34.9%) had MS treatment with ocrelizumab. Thirty-two (6.6%) patients reported that they were hospitalized;12 (37.5%) of these had been treated for MS with ocrelizumab. Fifty percent of pwMS who were treated in intensive care (7/14 patients) and died (3/6 patients) were being treated with ocrelizumab. As a result of the regression analysis, any additional risk factor on Covid-19 related to MS treatments was not detected, while working/being active in social life has a risk factor on the Covid-19 infection and it is course. Conclusion(s): The current data show that pwMS using ocrelizumab have a more severe course of Covid-19 infection than those using other DMTs. These data will guide the treatment of pwMS in cases of new Covid-19 variants or similar pandemic situations that may develop in the future.
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Introduciton: Multiple Sclerosis (MS) is an autoimmune disease with B-cell dysregulation playing an essential role in pathogenesis. As B-cells are also responsible for antibody production, their disfunction could also affect the humoral immune response against SARS-CoV-2 vaccines. Aim(s): To compare the immune response after messenger RNA (mRNA) BNT162b2 (Pfizer/BioNTech) and inactivated Coronavac vaccines in newly diagnosed treatment-naive MS (tnMS) patients and healthy controls (HC). Method(s): A single-center cross-sectional study evaluating antibody response against SARS-CoV-2 vaccines (inactivated vs mRNA) in HC and newly diagnosed and treatment-naive MS patients. Serum samples were collected at least two weeks after the second dose of the vaccine. The cutoff level of seropositivity is >= 50 antibody unit (AU)/ml. Result(s): 46 participants had two doses of inactivated Coronavac (35 HC and 11 tnMS), and 103 (57 HC and 46 tnMS) had two doses of mRNA. There was no significant difference in antibody response between HC and tnMS in the inactivated vaccine group. In the mRNA group, the antibody titers were significantly higher in HC (p=0.009), though no difference in the seropositivity rates was observed. Conclusion(s): Although MS is an autoimmune inflammatory disease, it does not affect immunity against the SARS-CoV-2 vaccine in treatment-naive patients.
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Introduction: Disease-modifying therapy (DMT) may decrease the immune response to COVID-19 vaccines, and the antibody response against SARS- CoV-2 is still not fully explored in people with multiple sclerosis(pwMS). Aim(s): To evaluate the immune response after messenger RNA (mRNA) BNT162b2 (Pfizer/BioNTech) and inactivated Coronavac vaccines in pwMS treated with a DMT compared to healthy controls(HC). Method(s): Patients who came to our MS unit for treatment or routine control were included in the study. Serum samples were collected at least two weeks after the second dose of the vaccine. The cutoff level or seropositivity is >= 50 antibody units (AU)/ml. The antibody titers were compared between HC and each treatment group. Result(s): 815 pwMS treated with DMT, 90 untreated MS patients and 92 healthy controls were enrolled in this single-center crosssectional study. In total, 500 (50.2%) participants received two doses of inactivated Coronavac, and 497(49.8%) received two doses of BNT162b2. In HC group, only one patient who had mRNA vaccine was seronegative. All patients on cladribine (n =14, 100%)and azathioprine (n=5) treatment have seropositive results in both vaccine types. Among treatment groups, fingolimod and ocrelizumab were associated with lower antibody titers (p<0.005). Only in fingolimod group, seropositivity rate was higher for mRNA vaccine compared to inactivated vaccine. The SARS CoV-2 antibody titer was significantly associated with mRNA vaccine [beta= 0.739 (0.067) 95%CI= 0.607;-0.870 p<0.001], EDSS [beta= -0.061 (0.024) 95%CI= -0.108;-0.013 p<0.012], time between second vaccine dose and sample collection dates [beta=-0.002 (0.001) 95%CI= -0.003;-0.001 p<0.001] and relapsing MS type [beta= -0.395 (0.136) 95%CI= -0.662;-0.127 p<0.004] Conclusion(s): Fingolimod and ocrelizumab therapy are associated with decreased immunity after SARS CoV2 vaccines. mRNA type of vaccine is the preferable choice in pwMS.
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Introduction: There is concern that people with neuromyelitis optica spectrum disorder (NMOSD, pwNMOSD) may be defenseless to developing coronavirus disease 2019 (Covid-19) due to immunosuppressive therapy. Moreover, there is limited information prognosis of Covid-19 in NMOSD. Aim(s): The study aims to investigate the relationship between the demographic, clinical, and therapeutic characteristics of the NMOSD cohort and the outcome of Covid-19 infection and compare it with the general population. Method(s): The whole NMOSD cohort, consisting of 90 people followed up at the Dokuz Eylul University Hospital, was interviewed at least once, face-to-face, via text message, or by phone, and the participants were questioned whether they were infected with Covid-19. The Covid-19 infection was detected in 19 pwNMOSD. A semi-structured phone interview consisting of 34 questions was done with all patients infected with Covid-19 infection, and detailed information about the Covid-19 infection course was obtained. Clinical information was obtained from the patient's medical records. Result(s): We identified 16 confirmed and three suspected (not confirmed with real-time PCR) pwNMOSD who had experienced Covid-19 infections. Three pwNMOSD have reinfection with Covid-19. The mean (SD) age, body mass index, disease duration, and Expanded Disability Status Scale score were 43.5 (13.9), 26.3 (5.3), 6 (6.6), and 2.5 (2), respectively. Of pwNMOSD, 17 (89.5%) were female, 12 (63.2%) were working. None of the participants reported smoking. Covid-19 cases (21.1%) were 1.4 times more common in our NMOSD population than in the general population (16.6%). The rate of Covid-19 infection course was the following: 3 (15.8%) people experienced severe, 1 (5.3%) people reported pneumonia which was treated in hospital, 16 (84.2%) people experienced mild, and no pwNMOSD died due to Covid- 19 infection. The most common reported symptoms were fever, cough, weakness, and musculoskeletal pain. The major differences were observed for rituximab between pwNMOSD with and without Covid-19 infection. Conclusion(s): Our results indicated that pwNMOSD appear to be at higher risk of contracting Covid-19 than the general population. However, most people with pwNMOSD recover mildly from the Covid-19 infection. Available data show that there is no need for additional concern for people with pwNMOSD in a similar pandemic that may develop in the future.
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Introduction/Objectives: Immunity after two doses of inactivated and messenger RNA(mRNA) SARS-CoV 2 vaccines in Multiple Sclerosis (MS) is influenced by the Disease-Modifying Therapy (DMT) and vaccine type used. Being lower in fingolimod, ocrelizumab, and inactivated vaccine groups. A booster dose could change this discrepancy. Aim(s): To compare the immunogenicity of a booster dose of mRNA BNT162b2 (Pfizer/BioNTech) versus inactivated vaccine, performed after completing two doses of inactivated Coronavac in people with MS (pwMS). Method(s): pwMS and Healthy Controls (HC) who received a booster dose of SARS-CoV 2 mRNA or inactivated vaccine after completing two doses of inactivated Coronovac were enrolled in this single-center cross-sectional study. Serum samples were collected at least two weeks after the third dose of the vaccine. The antibody titers were compared between HC, MS, and each treatment group. Result(s): Each of 339 pwMS and 52 HC received three doses of SARS-CoV-2 vaccines. 283 (72,3%) participants received a booster dose of mRNA, and 108 (27,7%) participants received a booster dose of inactivated Coronavac. In all comparisons, patients treated with ocrelizumab had the lowest antibody titer (p<0.005). In the fingolimod group, booster mRNA caused a higher antibody titer than the inactivated vaccine. In total, pwMS had a lower antibody titer than HC regardless of the vaccine type. In regression analyses having a booster mRNA [beta= -0.671 (0.133) 95%CI= -0.933 - -0.409, p<0.001] and lower disease duration [beta-0.019 (0.010)95%CI= -0.038 - 0.000, p=0.44] were two markers which significantly associated with higher antibody titer in pwMS. Conclusion(s): The study shows that a third dose vaccine is an effective strategy to boost antibody response in the MS population, and the mRNA SARS CoV-2 vaccine's booster is preferable to inactivated ones.
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Introduction: The COVID-19 pandemic has brought unprecedented challenges for patients living with multiple sclerosis (MS). MS and MS-specific treatments have been suggested as predisposing factors for c-19 infection without any robust confirmative real-world evidence. Objectives: We investigated the incidence and predisposing factors of c-19 infection in MS patients Methods: A prospective cohort including data of 3560 MS patients have been used to analyze the COVID-19 incidence and predisposing factors by using univariate analysis. Results: From Feb 2020 to May 2021;3560 MS patients (mean age of 42.6 years, 69.4% female. 89.4% RRMS) have been followed and 168 patients (incidence of 4.7% 95%CI: 4.1%-5.5%) had COVID-19. Of the 168 patients;78.9% were PCR positive and 88.8% had asymptomatic or mild COVID-19 infection;98.7% recovered completely and 2 (1.3%) patients died due to exacerbation of another chronic disease. Gender did not increase COVID-19 infection risk but being under 40 years (risk ratio-RR-=1.83;P<0.001) and being employed (RR= 1.73;p=0.002) increased the risk. Having RRMS (RR=2.09;p=0.025), having EDDS ≤1.5 (RR:1.80;p=0.001) and not using MS treatment (RR=2.08;p= 0.047) increased COVID-19 infection risk whereas no risk difference was detected between MS treatment types. Conclusions: Covid-19 incidence among MS patients (4.7%) was lower compared to the entire population in Turkey (5.8%) at the time of the analysis. Our results supported that patients who could maintain normal life during pandemic (i.e., being <40 years and employed, having low EDDS and being RRMS) were at higher risk;these findings suggested that exposure to high-risk environments, not being MS patient, was the main risk factor for COVID- 19 infection. Finally using MS-specific treatment didn't increase risk as controversially suggested so before.
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In time of crisis, the role of public institutions is on the rise and the communication between citizens and institutions is increasingly important, in order to preserve society's civic fabric and ensure the maintenance of trust in the aftermath of the crisis. This study analyzes communication patterns between Gen Z citizens and public institutions in a time of crisis. Through a qualitative process, the article evaluates the levels of trust in public institutions, as trust is a main concept and indicator in relationship building and a predictor of commitment, and it provides recommendations based on relationship marketing communication principles. The research was based on 86 interviews carried out in Romania with Generation Z participants. The article adopts an anticipatory approach towards communication, because once society's normal functioning resumes, albeit in a changing environment, citizens' trust and commitment and the maintaining of civic ties are paramount. © 2021. Felicia A. STANCIOIU, Nicolae A. POP, Raluca NASTASE ANYSZ and Cristina A. BABA.
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BACKGROUND: The pandemic of the new type of corona virus infection 2019 [Covid-19] also affect people with Multiple Sclerosis (pwMS). Currently, the accumulating information on the effects of the infection regarding the demographic and clinical characteristics of the disease, as well as outcomes within different DMTs¸ enable us to have better practices on the management of the Covid-19 infection in pwMS. OBJECTIVE: To investigate the incidence of coronavirus disease 2019 (Covid-19) and to reveal the relationship between the demographic-clinical and therapeutic features and the outcome of Covid-19 infection in a multi-center national cohort of pwMS. METHODS: The Turkish Neurological Society-MS Study Group in association with the Italian MuSC-19 Study Group initiated this study. A web-based electronic Case Report Form (eCRF) of Study-MuSC-19 were used to collect the data. The demographic data and MS histories of the patients were obtained from the file tracking forms of the relevant clinics. RESULTS: 309 MS patients with confirmed Covid-19 infection were included in this study. Two hundred nineteen (219) were females (70.9%). The mean age was 36.9, ranging from 18 to 66, 194 of them (62.8%) were under 40. The clinical phenotype was relapsing-remitting in 277 (89.6%) and progressive in 32 (10.4%). Disease duration ranged from 0.2 years to 31.4 years. The median EDSS was 1.5, ranging from 0 to 8.5. The EDSS score was<= 1 in 134 (43%) of the patients. 91.6% of the patients were on a DMT, Fingolimod was the most frequently used drug (22.0%), followed by Interferon (20.1%). The comorbidity rate is 11.7%. We were not able to detect any significant association of DMTs with Covid-19 severity. CONCLUSION: The Turkish MS-Covid-19 cohort had confirmed that pwMS are not at risk of having a more severe COVID-19 outcome irrespective of the DMT that they are treated. In addition, due to being a younger population with less comorbidities most had a mild disease further highlight that the only associated risk factors for having a moderate to severe COVID-19 course are similar with the general population such as having comorbid conditions and being older.
Subject(s)
COVID-19 , Multiple Sclerosis , Adult , Cohort Studies , Female , Fingolimod Hydrochloride , Humans , SARS-CoV-2ABSTRACT
At present, every live human being is worrying of COVID-19 and its varying forms to be attacked and its consequences. To invent the drug and vaccine, it is becoming a harder task that makes people hard to survive with this disease. Many people are getting this covid-19 because of contaminated environment as well as un-disciplinary actions. To avoid the spreading of COVID-19, the populace has to be aware with several sectors such as use of sanitizer, drinking of hot water, having of nutrition drink and hygiene food, and last but not the least consumption of immunity boosters. In this paper, we focus on developing an eco-friendly mask which not only prevents against COVID-19 but also purifies the air intake. The objective of this invention is to fight efficiently against COVID-19 pandemic in terms of preventing the spreading of Corona virus. The performance of this mask is validated against the conventional mask by considering and its maintenance will judge the success of this in the global mass society. Not only to face COVID, but also to face the pandemics to be raised in the future too. Hence, the proposed materialistic method using corona sensor will guide about corona surfaces and objects in the surrounding environment. © Published under licence by IOP Publishing Ltd.