Nursing care of patients with multiple sclerosis during the COVID-19 pandemic

Introduction: At the beginning of the SARS-CoV-2 pandemic, health centres were places where there was a high risk of infection, and during the period of lockdown face-to-face health care was substantially reduced, forcing rapid changes in the care of multiple sclerosis patients by the specialised nursing staff in the units and monographic consultations of this disease. Development: The experience of the nursing staff of multiple sclerosis units and monographic consultations, in 8 Spanish hospitals, is collected from the beginning of the pandemic and in later stages, and the adaptations that they made to continue caring for patients are specifically described. The scientific literature about how the SARS-CoV-2 has affected patients with multiple sclerosis is also reviewed, as well as the experiences of other multiple sclerosis teams in health centres in other countries. Conclusions: During the lockdown and in later stages, new forms and previously little used forms of care were applied to multiple sclerosis patients. The nursing staff kept contact with them by telephone and online, provided them with information about safety and behaviour in relation to COVID-19. Face-to-face visits, treatments and distribution of medication were adapted. Information was provided about how patients could receive psychosocial support and about how they could maintain their quality of life.

COVID-19 lockdown impact on labor and psycosocial aspects in multiple sclerosis patients

Introduction: Lockdown derived from Covid-19 pandemic may have an impact in different aspects of daily living in our patients. We should acknowledge them to better identify any posterior complication, not only clinical but also psychosocial. Objectives and Aims: We study the impact of lockdown and sanitary emergency in multiple sclerosis (MS) patients. Methods: Epidemiological retrospective observational study in MS patients during sanitary emergency. Data was collected on consumption of alcohol, tobacco and other drugs, physical activity and diet, labor, fatigue and mood, therapeutic adherence, and lack of attendance to consultations and analysis. Surveys were made: Beck Depression's inventory (BDI) and Modified Fatigue Impact Scale (MFIS). Results: Surveys were made to 101 patients. Median age was 42,83±9,46 years old with a median time of evolution of 11,61±6,97 years with a median EDSS of 2,8 ±2. Of all patients with previous toxic habits (30,7% tobacco, 9,9% alcohol consumption and 4% cannabis) 15,8% changed frequency of previous consumption during lockdown. 51,5% admitted having more fear of infection. 5% admitted lack of correct adherence to treatment and 30,7% skipped some of the consultations or analysis. Labor changes were detected in 16,8% of patients and 46,5% referred deterioration in their quality of life. 68,3% described changes in their diet and 62,4% in their daily physical activity. 23,8% and 18,8% respectively saw their modo and fatigue deteriorated. In BDI median score was 13,5±9,5 and in MFIS 33,89±18,28. Conclusions: Covid-19 lockdown has had an overall impact on different medical, labor, and psychosocial aspects in MS patients. Another study was conducted in our center about long-term effects of lockdown in our patients. Both studies, together, may help us to understand better the side effects derived from this pandemic.

The impact of the COVID-19 pandemic on multiple sclerosis patients: One year later

Introduction: Nowadays, Covid-19 pandemic seriously impact in general population mental status and quality of life. It is uncertain how these situation affect Multiple Sclerosis patients. Objectives: Analyze impact of Covid-19 pandemic in the quality of life in patients of a monographic Multiple Sclerosis Unit in a Spanish third level Hospital after one year Methods: Descriptive prospective study which analyzes changes in employment status, smoking habit, patient report outcomes (PROs) and Covid-19 incidence. Demographic variables (sex, age, employment status, smoking habit), and clinical (disease duration, EDSS, Covid-19 symptoms and PROs) were analyzed. Results: 100 patients Multiple Sclerosis. Median age 42.2 (SD 8.8). 74 % women. Disease duration: 11 years (1 - 37). EDSS 2 (0 - 7.5). 31 % was smoking in first evaluation. 83.3 % will not change after one year. In first assesment 47 % has an employment;1 % sick leave, 29 % inactive because disability;8 % pensioner, 9 % unemployement, 6 % another situation. In second evaluation 89.8 % does not change. 90.8 % have not Covid symptoms after one year and 3.1 % has infected SARS-Cov-2. 36 patients completed PROs in first evaluation and 25 in both. First MFIS median 34.8 (SD 17.13): physical 17.2 (SD 8.76), cognitive 15.75 (SD 9.25). Final MFIS median 38.4 (SD 17.38): physical 17.2 (SD 8.66), cognitive 17.56 (SD 10.3). Initial BDI 13.66 (SD 9.43);final BDI 11.21 (SD 9). Initial EuroQol 0.73 (SD 0.23);final 0.76 (SD 0.19). Conclusion: It does not seem that pandemic situation would have a negative impact about depression or anxiety in our patients. However, we observe a change in fatigue (physical and cognitive). It would be because of increase of sedentary life or the recently described “pandemic fatigue”.