ABSTRACT
Introduction: It seems that Multiple sclerosis (MS) patients are at the higher risk for COVID-19 implications due to the use of immunomodulatory or immunosuppressive treatments. Obesity as a risk factor may lead to more adverse consequences. Relationship between obesity and COVID-19 risk and outcome in Iranian MS patients still remains unclear. We aimed to investigate the impact of BMI as a modifiable risk factors on the risk and outcomes of COVID-19 in Iranian patients with MS. Material(s) and Method(s): A cross-sectional study was conducted in the Sina hospital, Tehran, Iran. MS patients were asked to complete an online questionnaire in the google form format. Demographic information, clinical data consisting of MS disease-related factors, COVID-19-related factors, and anthropometric information were collected. In total, 492 patients were filled the questionnaire. BMI was categorized considering WHO's standard classification as underweight (BMI<18.5), normal weight (BMI>=18.5 and <25), overweight (BMI>=25 and <30), obesity type I (BMI>=30 and <35), and obesity type II (BMI>=35) (3). Result(s): The mean age was 36.7+/-8.2 and 395(80.3%) of them were women. 350(71.1%) of participants were suffered from RRMS. The most received MS drugs was Rituximab (36.0%). The mean BMI was 24.3+/-4.5 kg/m2. 234(47.6%) participants reported COVID-19 infection during the pandemic. 465(94.5%) of them were two doses vaccinated and 15(3%) of them were one-dose vaccinated. The odds ratio of COVID-19 infection was significantly 4.41 times more than the normal group in the type 2 obesity category (OR:5.41;95%CI:1.00-29.09) in the fully adjusted regression model. COVID-19 severity was significantly different in BMI groups (P:0.02), So that 11(8.6%) patients in normal weight group and 4(50%) of patients in type II obesity group were hospitalized due to COVID-19 infection. Respiratory symptoms (P:0.05) and gastrointestinal symptoms (P<0.01) were more prevalent among types I and II of obesity. On the other hand, no one in the obesity type I and II reported COVID-19 infection without any symptoms (P:0.04). Conclusion(s): The results of current study support that obesity could play a key role in susceptibility to COVID-19 infection and symptoms severity in MS patients. One of the issues that emerge from these findings is recommended that neurologists pay more attention on patients' BMI during this pandemic.Copyright © 2022
ABSTRACT
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disease of the central nervous system with astrocytopathy characteristics. Antibodies against aquaporin-4 water channels which are mainly located in astrocyte podocytes play an important role in NMOSD pathogenesis. Like other autoimmune disorders, it seems that both genetic and environmental factors are involved in NMOSD risk, but the role of environmental risk factors is more significant. Infections are known to be an effective factor not only in the incidence but also in the exacerbation of autoimmune diseases. In this chapter, the roles of microorganisms in two categories of viruses and bacteria in the pathogenesis and management of NMOSD patients are discussed. In this regard the relation between infection with tuberculosis, Helicobacter pylori, Epstein-Barr virus, SARS-CoV-2, varicella-zoster virus, dengue virus, cytomegalovirus, herpes simplex virus 2 and Zika virus, as well as gut microbiome and NMOSD occurrence are mentioned. On the other hand, susceptibility of NMOSD patients for developing infectious diseases due to receiving immunosuppressive drugs and the role of infection in NMOSD attack and disease exacerbation are outlined. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.
ABSTRACT
Background: Recent Covid-19 outbreak around the world turned into an international public health concern. Generally, people who receives immunosuppressive treatments or have an underlying disease are more likely to be infected. Multiple sclerosis (MS) patients also may have higher risk of infection due to the taking immunosuppressive or immunomodulatory drugs. Our objectives were to identify the epidemiological characteristics of Covid-19 in patients with MS for improve quality of care and achievement to better diagnosis and treatment in MS patients in Iran. Material(s) and Method(s): The present data were obtained from a hospital-based registry in Imam Khomeini hospital, Tehran, Iran. Totally, 88 MS patients who was infected by Covid-19 were registered from May, 2020 to March 2021. Demographic and clinical data was collected (2). Result(s): 55 (65.5%) of participants were female by the mean age (SD) of 37.48 ± 10.05 years. Covid-19 diagnosis of 4 (4.5%) of patients was based on positive PCR test. The most MS treatment was receiving by patients was Rituximab (20 (22.7%)) following by Dimethyl Fumarate (14 (15.9%)), Fingolimod (10 (11.4%)), Glatiramer acetate (8 (9.1%)), Interferon β-1a (IM) (5 (5.7%)), Interferon β-1a (SQ) (5 (5.7%)), Interferon β-1b (3 (3.4%)), Triflunomide (2 (2.3%)) and Natalizumab (1 (1.1%)). The mean (SD) interval from the last Rituximab injection to Covid-19 infection was 3.80 ± 3.40 months. 37 (42.0%) MS patients continued to take their drugs after Covid-19 infection, while 10 (11.4%) of them stopped taking MS medicine and 7 (8.0%) of them was taking no treatment for controlling MS. 2 (2.3%) of participants was diagnosed by MS after Covid-19 infection. 9 (9.7%) subjects hospitalized due to Covid-19 infection. The mean (SD) duration of hospitalization was 5 ± 7.81 days. One (1.1%) death cases was reported. Conclusion(s): Our findings revealed valuable data of Covid-19 characteristics in patients with MS which could be useful for improving health services for MS patients during the Covid-19 pandemic (3-4).
ABSTRACT
The new pandemic coronavirus disease 2019 (COVID-19) that is caused by a new strain of coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), has become an issue for governments and health care providers such as specialists including psychiatrists worldwide (1). Treatment strategies and vaccination for this disease are yet to be explored. Therefore, at this time, the best-proposed health measure to break the chain of transmission is social distancing or, in some instances, quarantine. In a recent systematic review published in Lancet, Brooks et al. (2) evaluated the psychological impacts of quarantine during the 2003 SARS outbreak and the 2014 Ebola outbreak. Accordingly, most of the reviewed studies reported adverse psychological effects, including post-traumatic stress symptoms, confusion, and anger (2). Delays in psychological interventions in such situations can lead to psychological damage to individuals who are involved (3). However, people with a pre-existing mental health problem such as anxiety or depressive disorder would be more vulnerable to experience adverse psychological effects of quarantine and social distancing.