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BACKGROUND: To date, there are no data available on the safety of COVID-19 vaccines in Latin American patients with Multiple Sclerosis (MS). OBJECTIVE: Characterize safety of COVID-19 vaccines in Latin American (LATAM) patients with Multiple Sclerosis (pwMS). METHODS: A cross-sectional study between February 1, 2021, and April 30, 2021. Individuals with MS from LATAM countries were invited to participate in a self-administered web-based survey, through MS patient organizations from the region. RESULTS: 393 vaccinated pwMS from 10 different Latin American countries were included. The vaccines administered were: inactivated virus vaccines (IVV) in 38.2% of patients, adenovirus vector vaccines (AdV) in 48.8% and mRNA vaccines 13%. All patients received at least one dose of any of the COVID-19 vaccines and 123 (31.3%) declared receiving a second dose. Mean (SD) age 41.5 (11.8) years, 82.4% female, MS disease duration: 8.4 (8.2) years. No serious adverse events were reported with any of the COVID-19 vaccines after either the first or second dose. A lower frequency of adverse events was found with IVV (22%) in comparison with AdV (46.4%) and mRNA (35.3%) (p < 0.01). Five participants reported having an MS relapse after IVV first dose. CONCLUSION: COVID-19 vaccines applied in LATAM proved safe for MS patients.
ABSTRACT
RESUMEN Introducción: Un estilo de vida poco saludable tendría influencia negativa en la evolución de la esclerosis múltiple (EM). La pandemia de Covid-19 ha producido cambios que podrían haber modificado el mismo. Los objetivos fueron evaluar aspectos del estilo de vida de personas con EM (pcEM) integrantes de una asociación de pacientes de Argentina, previo y durante la pandemia, las causas de éste y si recibieron consejos médicos sobre el tema. Sujetos y métodos: Estudio observacional, pcEM fueron convocadas a través de una asociación de pacientes para responder encuestas on line en noviembre de 2019 y octubre 2020. Se recolectaron datos demográficos, de la enfermedad, talla, peso, tabaquismo, alimentación, actividad física, consumo de alcohol y sobre la atención médica. Resultados: 208 pcEM. Mujeres: 76,4%. 43,76 años (+/- 10,7). Cumple con la actividad física recomendada40,4%, 5 porciones de frutas y verduras diarias 13,9%, tabaquismo 24,5%, consumo de alcohol de riesgo 12,5%, sobrepeso + obesidad 53,4%. En pandemia disminuyó el tabaquismo (24,9% vs 20% p=0.004), aumentó el peso (BMI=26,1 vs 27,4 p=0,001) y disminuyó la actividad física (39,3% vs 31,5% p=0,016). Recibió regularmente consejos sobre ejercicio físico el 54,3%, dieta saludable 32,4%, cesación tabáquica 33,3%. Conclusiones: Un importante porcentaje de las pcEM presentan aspectos del estilo de vida no saludables. En pandemia se observó, aumento de peso, aumento del sedentarismo y disminución del tabaquismo. No se realizaron frecuentemente los consejos sobre estilo de vida. Son necesarios nuevos estudios para evaluar cómo mejorar el estilo de vida y su implicancia en la evolución y la calidad de vida. ABSTRACT Introduction: An unhealthy lifestyle could have a negative influence on the evolution of multiple sclerosis (MS). Due to the Covid-19 pandemic there has been changes that could have affect the lifestyle. The objectives were to evaluate aspects of the lifestyle of people with MS (pcEM) who are members of an association of patients from Argentina, prior to and during the pandemic, its causes and whether they received medical advice on the subject. Subjets and methods: Observational study, pwMS were convened through a patient association to answer online surveys in November 2019 and October 2020. Demographic, disease, height, weight, smoking, diet, physical activity, alcohol consumption and medical care data were collected. Results: 208 pwMS. Women: 76.4%. 43.76 years (+/- 10.7). Meets recommended physical activity 40.4%, 5 servings of fruits and vegetables daily 13.9%, smoking 24.5%, risk alcohol consumption 12.5%, overweight + obesity 53.4%. In the pandemic, smoking decreased (24.9% vs 20% p=0.004), weight increased (BMI=26.1 vs 27.4 p=0.001) and physical activity decreased (39.3% vs 31.5% p=0.016). Regularly received advice on physical exercise 54.3%, healthy diet 32.4%, smoking cessation 33.3%. Conclusions: A significant percentage of the pwMS present unhealthy aspects of lifestyle. In the pandemic was observed: weight gain, an increase of sedentary lifestyle and a decrease in smoking. Lifestyle advice was not done frequently. Further studies are needed to assess how to improve lifestyle and its implications for evolution and quality of life.
ABSTRACT
BACKGROUND: The COVID-19 pandemic has resulted in uncertain access to medical treatment for people with multiple sclerosis (pwMS) all over the world. However, there is no data regarding its impact on access to health care of pwMS from Latin America. OBJECTIVES: We investigated and described changes in health care delivery for pwMS from Latin America during the COVID-19 pandemic. METHODS: PwMS from 18 patient organizations of the region completed a web-based survey hosted from May to October 2020. RESULTS: A total of 602 pwMS completed the questionnaire. Changes in disease-modifying therapies (DMTs) use: 6.7% of pwMS on continuous DMTs claimed to stopped them; 14.1% of those on infusion therapies declared to postpone their dosing; 68.8% declared delaying the initiation of a DMT. Disruptions in accessing rehabilitation services were reported by 65.7%. Changes in laboratory and MRI monitoring were reported by 30% and 33%, respectively. In a multivariable-adjusted logistic regression model, changes in laboratory monitoring were significantly associated with increased odds of postponing MRI monitoring (OR 4.09 CI95% 2.79-6.00, p < 0.001). CONCLUSIONS: The COVID-19 pandemic has disrupted all aspects of the routine care for pwMS from Latin America. Consequences are yet to be determined.
Subject(s)
COVID-19 , Multiple Sclerosis , Delivery of Health Care , Humans , Latin America/epidemiology , Multiple Sclerosis/epidemiology , Multiple Sclerosis/therapy , Pandemics , SARS-CoV-2ABSTRACT
As human and economic resources are limited, especially in Latin America (LATAM), it is important to identify research priorities to improve multiple sclerosis (MS) patients care in the region. The objective was to generate a multidisciplinary consensus on research priorities in MS for patients care in LATAM by involving healthcare professionals and MS patient associations. METHODS: consensus was reached through a four-step modified Delphi method designed to identify and rate research priorities in MS in LATAM. The process consisted of two qualitative assessments, a general ranking phase and a consensus meeting followed by a more detailed ranking phase RESULTS: a total of 62 participants (35 neurologists, 4 nurses, 12 kinesiologists, 7 neuropsychologists and 4 patient association members) developed the process. At the final ranking stage following the consensus meeting, each participant provided their final rankings, and the top priority research questions were outlined. 11 research priorities were identified focusing on healthcare access, costs of the disease, physical and cognitive evaluation and rehabilitation, quality of life, symptoms management, prognostic factors, the need of MS care units and patient's management in emergencies like COVID-19. CONCLUSION: this work establishes MS research priorities in LATAM from multiple perspectives. To pursue the actions suggested could launch the drive to obtain information that will help us to better understand the disease in our region and, especially, to better care for affected patients.