ABSTRACT
Introduction: Multiple Sclerosis (MS) is a disabling chronic disease with clinical heterogeneity and uncertain prognosis. Evaluating the health-related quality of life (HRQoL) of patients is important for the multidisciplinary therapeutic approach including physical, psychic and social aspects that influence the wellbeing of people with consequences in the course of the disease. As of March 2020 due to the Coronavirus 2019 (COVID-19) pandemic and quarantine measures, habits and access to the health system have been substantially modified. Objective(s): Our aim was to evaluate depression level and HRQoL of MS patients and compare this results with pre-pandemic assessment (2019). Patients and Methods: A cross-sectional study was conducted between March and July 2021. Measuring instruments: Clinical, HRQoL: Multiple Sclerosis International Quality of Life questionnaire (MusiQol), Depression: Beck Depression Inventory II (BDI-II), and pandemic-related aspects using a ad-hoc questionnaire. The results of MusiQol and BDI-II were compared with those obtained from the 2019 evaluations. Parametric and nonparametric statistics were used, to define significance a value of p <0.05 was accepted. Result(s): We evaluated 62 patients. In the comparative analysis with 2019, a significant decrease in HRQoL was observed (z=- 2.21, p=0.03). The affected domains were activities of daily living, psychological well-being, and sexual and sentimental life. In contrast, no significant changes were observed in the assessment of depression using BDI-II (z=-0.39, p=0.69). Conclusion(s): HrQoL of MS patients is decreased compared to 2019. The pandemic itself, health and quarantine measures have negatively impacted on HRQoL, substantially impairing patients' performance in activities of daily living, psychological wellbeing, and sexual and sentimental life.
ABSTRACT
Introduction: Las inflamaciones periféricas pueden exacerbar lesiones pre-existentes en el Sistema Nervioso Central en contexto de enfermedades neurodegenerativas, incluyendo la Esclerosis Múltiple (EM). Objetives: Analizar el efecto de la infección por COVID-19 como generador de inflamación periférica en un grupo de pacientes con EM. Methods: Análisis retrospectivo de 400 historias clínicas de pacientes con EM de un centro de referencia. A los pacientes que presentaron COVID-19 se les realizó una encuesta sobre la presencia o ausencia de exacerbación de síntomas previos de EM durante la infección y hasta tres meses posterior a ella. Se incluyó: tipo de síntoma, duración y comienzo de la exacerbación, vacunación previa contra COVID-19 y severidad de la enfermedad. Además, se incluyó información clínica y demográfica de las historias clínicas. Se realizó un análisis descriptivo e inferencial utilizando el GraphPad Prism V6. Results: 41 pacientes fueron incluidos, 58,5% fueron mujeres y la edad promedio fue de 42.9 ± 11.3. 90,2% presentaban la forma remitente-recurrente (EMRR), el promedio de años de evolución de EM fue de 9.6 ± 6.60 y el EDSS promedio fue de 2.4 ± 2.1. 25 pacientes (61%) tuvieron exacerbaciones de EM, 9,7% (n=4) presentaron síntomas compatibles con recaídas y 7,3% (n=3) requirieron corticoides. Encontramos diferencias significativas en el EDSS entre los pacientes que exacerbaron sus síntomas de EM y los que no (p=0,03). Al efectuar un análisis de regresión multivariada encontramos que el EDSS se asoció de forma independiente a la presencia de exacerbaciones de la EM en contexto de infección por SARS CoV2 (OR= 2.44, p =0.022). Conclusions: Este estudio preliminar sugiere que la infección por COVID-19 podría desencadenar exacerbaciones de síntomas de la EM. Se necesitan nuevos estudios que diluciden la relación entre COVID-19 y EM.
ABSTRACT
Introduction: Patients with MS (pwMS) are currently receiving different COVID-19 vaccines in several Latin American countries. However, questions arise around the safety of these vaccines and whether vaccination might increase the risk of relapse activity. Therefore, we aimed to assess the safety and occurrence of relapses following COVID-19 vaccination in Latin American pwMS. Methods: A web-based survey was completed by 207 pwMS from Latin America to assess for adverse events associated with COVID-19 vaccination between February 1 and April 30, 2021. Results: All participants received the first dose and 84 the second. The different vaccines administered were: inactivated virus vaccines [(IVV);CoronaVac, BBIBP-CorV) ] in 117 (56.5%) patients, adenovirus vector vaccines [(AdV);Gam-COVID-Vac, AZD1222] in 53 (25.6%) and mRNA vaccines (BNT162b2) in 37 (17.9%). The mean follow-up after vaccination was 24 ± 16 days. Three (1.4%) patients reported having COVID-19 infection after vaccination (all occurring after the first dose). Any adverse events were reported in 61 (29.5%) and 23 (27.4%) individuals after the first and second doses respectively. These included pain at the injection site, headache, fever, flu-like symptoms, fatigue, and muscle or joint pain. A lower frequency of adverse events was found with IVV (x?=7.2, p=0.03). Four (1.9%) patients reported an MS relapse, all occurring after an IVV first dose. Mean time to relapse: 18 ± 13 days. None of these patients had stopped or postponed their MS treatment before vaccination. Conclusion: COVID-19 vaccines seem to be safe for pwMS from Latin America. No major safety signals appeared in this patientreported study.