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Micah, Angela E.; Bhangdia, Kayleigh, Cogswell, Ian E.; Lasher, Dylan, Lidral-Porter, Brendan, Maddison, Emilie R.; Nguyen, Trang Nhu Ngoc, Patel, Nishali, Pedroza, Paola, Solorio, Juan, Stutzman, Hayley, Tsakalos, Golsum, Wang, Yifeng, Warriner, Wesley, Zhao, Yingxi, Zlavog, Bianca S.; Abbafati, Cristiana, Abbas, Jaffar, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abdelmasseh, Michael, Abdulah, Deldar Morad, Abedi, Aidin, Abegaz, Kedir Hussein, Abhilash, E. S.; Aboagye, Richard Gyan, Abolhassani, Hassan, Abrigo, Michael R. M.; Abubaker Ali, Hiwa, Abu-Gharbieh, Eman, Adem, Mohammed Hussien, Afzal, Muhammad Sohail, Ahmadi, Ali, Ahmed, Haroon, Ahmed Rashid, Tarik, Aji, Budi, Akbarialiabad, Hossein, Akelew, Yibeltal, Al Hamad, Hanadi, Alam, Khurshid, Alanezi, Fahad Mashhour, Alanzi, Turki M.; Al-Hanawi, Mohammed Khaled, Alhassan, Robert Kaba, Aljunid, Syed Mohamed, Almustanyir, Sami, Al-Raddadi, Rajaa M.; Alvis-Guzman, Nelson, Alvis-Zakzuk, Nelson J.; Amare, Azmeraw T.; Ameyaw, Edward Kwabena, Amini-Rarani, Mostafa, Amu, Hubert, Ancuceanu, Robert, Andrei, Tudorel, Anwar, Sumadi Lukman, Appiah, Francis, Aqeel, Muhammad, Arabloo, Jalal, Arab-Zozani, Morteza, Aravkin, Aleksandr Y.; Aremu, Olatunde, Aruleba, Raphael Taiwo, Athari, Seyyed Shamsadin, Avila-Burgos, Leticia, Ayanore, Martin Amogre, Azari, Samad, Baig, Atif Amin, Bantie, Abere Tilahun, Barrow, Amadou, Baskaran, Pritish, Basu, Sanjay, Batiha, Abdul-Monim Mohammad, Baune, Bernhard T.; Berezvai, Zombor, Bhardwaj, Nikha, Bhardwaj, Pankaj, Bhaskar, Sonu, Boachie, Micheal Kofi, Bodolica, Virginia, Botelho, João Silva Botelho, Braithwaite, Dejana, Breitborde, Nicholas J. K.; Busse, Reinhard, Cahuana-Hurtado, Lucero, Catalá-López, Ferrán, Chansa, Collins, Charan, Jaykaran, Chattu, Vijay Kumar, Chen, Simiao, Chukwu, Isaac Sunday, Dadras, Omid, Dandona, Lalit, Dandona, Rakhi, Dargahi, Abdollah, Debela, Sisay Abebe, Denova-Gutiérrez, Edgar, Desye, Belay, Dharmaratne, Samath Dhamminda, Diao, Nancy, Doan, Linh Phuong, Dodangeh, Milad, dos Santos, Wendel Mombaque, Doshmangir, Leila, Dube, John, Eini, Ebrahim, El Sayed Zaki, Maysaa, El Tantawi, Maha, Enyew, Daniel Berhanie, Eskandarieh, Sharareh, Ezati Asar, Mohamad, Fagbamigbe, Adeniyi Francis, Faraon, Emerito Jose A.; Fatehizadeh, Ali, Fattahi, Hamed, Fekadu, Ginenus, Fischer, Florian, Foigt, Nataliya A.; Fowobaje, Kayode Raphael, Freitas, Alberto, Fukumoto, Takeshi, Fullman, Nancy, Gaal, Peter Andras, Gamkrelidze, Amiran, Garcia-Gordillo, M. A.; Gebrehiwot, Mesfin, Gerema, Urge, Ghafourifard, Mansour, Ghamari, Seyyed-Hadi, Ghanbari, Reza, Ghashghaee, Ahmad, Gholamrezanezhad, Ali, Golechha, Mahaveer, Golinelli, Davide, Goshu, Yitayal Ayalew, Goyomsa, Girma Garedew, Guha, Avirup, Gunawardane, Damitha Asanga, Gupta, Bhawna, Hamidi, Samer, Harapan, Harapan, Hashempour, Reza, Hayat, Khezar, Heidari, Golnaz, Heredia-Pi, Ileana, Herteliu, Claudiu, Heyi, Demisu Zenbaba, Hezam, Kamal, Hiraike, Yuta, Hlongwa, Mbuzeleni Mbuzeleni, Holla, Ramesh, Hoque, Mohammad Enamul, Hosseinzadeh, Mehdi, Hostiuc, Sorin, Hussain, Salman, Ilesanmi, Olayinka Stephen, Immurana, Mustapha, Iradukunda, Arnaud, Ismail, Nahlah Elkudssiah, Isola, Gaetano, J, Linda Merin, Jakovljevic, Mihajlo, Jalili, Mahsa, Janodia, Manthan Dilipkumar, Javaheri, Tahereh, Jayapal, Sathish Kumar, Jemere, Digisie Mequanint, Joo, Tamas, Joseph, Nitin, Jozwiak, Jacek Jerzy, Jürisson, Mikk, Kaambwa, Billingsley, Kadashetti, Vidya, Kadel, Rajendra, Kadir, Dler Hussein, Kalankesh, Laleh R.; Kamath, Rajesh, Kandel, Himal, Kantar, Rami S.; Karanth, Shama D.; Karaye, Ibraheem M.; Karimi, Salah Eddin, Kassa, Bekalu Getnet, Kayode, Gbenga A.; Keikavoosi-Arani, Leila, Keshri, Vikash Ranjan, Keskin, Cumali, Khader, Yousef Saleh, Khafaie, Morteza Abdullatif, Khajuria, Himanshu, Khayat Kashani, Hamid Reza, Kifle, Zemene Demelash, Kim, Hanna, Kim, Jihee, Kim, Min Seo, Kim, Yun Jin, Kisa, Adnan, Kohler, Stefan, Kompani, Farzad, Kosen, Soewarta, Koulmane Laxminarayana, Sindhura Lakshmi, Koyanagi, Ai, Krishan, Kewal, Kusuma, Dian, Lám, Judit, Lamnisos, Demetris, Larsson, Anders O.; Lee, Sang-woong, Lee, Shaun Wen Huey, Lee, Wei-Chen, Lee, Yo Han, Lenzi, Jacopo, Lim, Lee-Ling, Lorenzovici, László, Lozano, Rafael, Machado, Vanessa Sintra Machado, Madadizadeh, Farzan, Magdy Abd El Razek, Mohammed, Mahmoudi, Razzagh, Majeed, Azeem, Malekpour, Mohammad-Reza, Manda, Ana Laura, Mansouri, Borhan, Mansournia, Mohammad Ali, Mantovani, Lorenzo Giovanni, Marrugo Arnedo, Carlos Alberto, Martorell, Miquel, Masoud, Ali, Mathews, Elezebeth, Maude, Richard James, Mechili, Enkeleint A.; Mehrabi Nasab, Entezar, Mendes, José João João Mendes, Meretoja, Atte, Meretoja, Tuomo J.; Mesregah, Mohamed Kamal, Mestrovic, Tomislav, Mirica, Andreea, Mirrakhimov, Erkin M.; Mirutse, Mizan Kiros, Mirza, Moonis, Mirza-Aghazadeh-Attari, Mohammad, Misganaw, Awoke, Moccia, Marcello, Moghadasi, Javad, Mohammadi, Esmaeil, Mohammadi, Mokhtar, Mohammadian-Hafshejani, Abdollah, Mohammadshahi, Marita, Mohammed, Shafiu, Mohseni, Mohammad, Mokdad, Ali H.; Monasta, Lorenzo, Mossialos, Elias, Mostafavi, Ebrahim, Mousavi Isfahani, Haleh, Mpundu-Kaambwa, Christine, Murthy, Shruti, Muthupandian, Saravanan, Nagarajan, Ahamarshan Jayaraman, Naidoo, Kovin S.; Naimzada, Mukhammad David, Nangia, Vinay, Naqvi, Atta Abbas, Nayak, Biswa Prakash, Ndejjo, Rawlance, Nguyen, Trang Huyen, Noroozi, Nafise, Noubiap, Jean Jacques, Nuruzzaman, Khan M.; Nzoputam, Chimezie Igwegbe, Nzoputam, Ogochukwu Janet, Oancea, Bogdan, Obi, Felix Chukwudi Abrahams, Ogunkoya, Abiola, Oh, In-Hwan, Okonji, Osaretin Christabel, Olagunju, Andrew T.; Olagunju, Tinuke O.; Olakunde, Babayemi Oluwaseun, Omar Bali, Ahmed, Onwujekwe, Obinna E.; Opio, John Nelson, Otoiu, Adrian, Otstavnov, Nikita, Otstavnov, Stanislav S.; Owolabi, Mayowa O.; Palicz, Tamás, Palladino, Raffaele, Pana, Adrian, Parekh, Tarang, Pasupula, Deepak Kumar, Patel, Jay, Patton, George C.; Paudel, Uttam, Paun, Mihaela, Pawar, Shrikant, Perna, Simone, Perumalsamy, Navaraj, Petcu, Ionela-Roxana, Piracha, Zahra Zahid, Poursadeqiyan, Mohsen, Pourtaheri, Naeimeh, Prada, Sergio I.; Rafiei, Sima, Raghav, Pankaja Raghav, Rahim, Fakher, Rahman, Mohammad Hifz Ur, Rahman, Mosiur, Rahmani, Amir Masoud, Ranabhat, Chhabi Lal, Raru, Temam Beshir, Rashedi, Sina, Rashidi, Mohammad-Mahdi, Ravangard, Ramin, Rawaf, Salman, Rawassizadeh, Reza, Redwan, Elrashdy Moustafa Mohamed, Reiner, Robert C.; Renzaho, Andre M. N.; Rezaei, Maryam, Rezaei, Nazila, Riaz, Mavra A.; Rodriguez, Jefferson Antonio Buendia, Saad, Aly M. A.; Saddik, Basema, Sadeghian, Saeid, Saeb, Mohammad Reza, Saeed, Umar, Sahu, Maitreyi, Saki, Morteza, Salamati, Payman, Salari, Hedayat, Salehi, Sana, Samy, Abdallah M.; Sanabria, Juan, Sanmarchi, Francesco, Santos, João Vasco, Santric-Milicevic, Milena M.; Sao Jose, Bruno Piassi, Sarikhani, Yaser, Sathian, Brijesh, Satpathy, Maheswar, Savic, Miloje, Sayadi, Yaser, Schwendicke, Falk, Senthilkumaran, Subramanian, Sepanlou, Sadaf G.; Serván-Mori, Edson, Setshegetso, Naomi, Seylani, Allen, Shahabi, Saeed, Shaikh, Masood Ali, Shakhmardanov, Murad Ziyaudinovich, Shanawaz, Mohd, Sharew, Mequannent Melaku Sharew, Sharew, Nigussie Tadesse, Sharma, Rajesh, Shayan, Maryam, Sheikh, Aziz, Shenoy, Suchitra M.; Shetty, Adithi, Shetty, Pavanchand H.; Shivakumar, K. M.; Silva, Luís Manuel Lopes Rodrigues, Simegn, Wudneh, Singh, Jasvinder A.; Singh, Kuldeep, Skhvitaridze, Natia, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Socea, Bogdan, Solomon, Yonatan, Song, Suhang, Ștefan, Simona Cătălina, Suleman, Muhammad, Tabarés-Seisdedos, Rafael, Tat, Nathan Y.; Tat, Vivian Y.; Tefera, Belay Negash, Tichopad, Ales, Tobe-Gai, Ruoyan, Tovani-Palone, Marcos Roberto, Tudor Car, Lorainne, Tufa, Derara Girma, Vasankari, Tommi Juhani, Vasic, Milena, Vervoort, Dominique, Vlassov, Vasily, Vo, Bay, Vu, Linh Gia, Waheed, Yasir, Wamai, Richard G.; Wang, Cong, Wassie, Gizachew Tadesse, Wickramasinghe, Nuwan Darshana, Yaya, Sanni, Yigit, Arzu, Yiğit, Vahit, Yonemoto, Naohiro, Younis, Mustafa Z.; Yu, Chuanhua, Yunusa, Ismaeel, Zaki, Leila, Zaman, Burhan Abdullah, Zangeneh, Alireza, Zare Dehnavi, Ali, Zastrozhin, Mikhail Sergeevich, Zeng, Wu, Zhang, Zhi-Jiang, Zuhlke, Liesl J.; Zuniga, Yves Miel H.; Hay, Simon I.; Murray, Christopher J. L.; Dieleman, Joseph L..
The Lancet Global Health ; 2023.
Article in English | ScienceDirect | ID: covidwho-2211782

ABSTRACT

Summary Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic;characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic;and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95% uncertainty interval [UI] 9·1–9·3) was spent on health worldwide. We found great disparities in the amount of resources devoted to health, with high-income countries spending $7·3 trillion (95% UI 7·2–7·4) in 2019;293·7 times the $24·8 billion (95% UI 24·3–25·3) spent by low-income countries in 2019. That same year, $43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health;in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and $37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained. Funding Bill & Melinda Gates Foundation.

2.
J Neurol Sci ; 439: 120306, 2022 08 15.
Article in English | MEDLINE | ID: covidwho-1867404

ABSTRACT

We reported on five people with MS, using immunodepleting disease modifying treatments (anti-CD20 monoclonal antibodies and sphingosine-one-phosphate modulators) and with reduced COVID-19 vaccine response, who had mild-to-moderate symptomatic COVID-19, and were treated with anti-SARS-CoV-2 monoclonal antibodies. In particular, we showed the possibility to use monoclonal antibodies to speed-up recovery from COVID-19 in MS, in the absence of any COVID-19 residuals or MS changes (e.g., relapses or disability).


Subject(s)
COVID-19 , Multiple Sclerosis , Antibodies, Monoclonal/therapeutic use , Antibodies, Viral , COVID-19 Vaccines , Humans , Multiple Sclerosis/complications , Multiple Sclerosis/drug therapy
4.
Neurol Sci ; 43(2): 1007-1014, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1669827

ABSTRACT

OBJECTIVES: To evaluate the concordance between Google Maps® application (GM®) and clinical practice measurements of ambulatory function (e.g., Ambulation Score (AS) and respective Expanded Disability Status Scale (EDSS)) in people with multiple sclerosis (pwMS). MATERIALS AND METHODS: This is a cross-sectional multicenter study. AS and EDSS were calculated using GM® and routine clinical methods; the correspondence between the two methods was assessed. A multinomial logistic model is investigated which demographic (age, sex) and clinical features (e.g., disease subtype, fatigue, depression) might have influenced discrepancies between the two methods. RESULTS: Two hundred forty-three pwMS were included; discrepancies in AS and in EDDS assessments between GM® and routine clinical methods were found in 81/243 (33.3%) and 74/243 (30.4%) pwMS, respectively. Progressive phenotype (odds ratio [OR] = 2.8; 95% confidence interval [CI] 1.1-7.11, p = 0.03), worse fatigue (OR = 1.03; 95% CI 1.01-1.06, p = 0.01), and more severe depression (OR = 1.1; 95% CI 1.04-1.17, p = 0.002) were associated with discrepancies between GM® and routine clinical scoring. CONCLUSION: GM® could easily be used in a real-life clinical setting to calculate the AS and the related EDSS scores. GM® should be considered for validation in further clinical studies.


Subject(s)
Multiple Sclerosis , Search Engine , Cross-Sectional Studies , Disability Evaluation , Fatigue/diagnosis , Fatigue/epidemiology , Humans , Multiple Sclerosis/diagnosis
5.
J Clin Psychol Med Settings ; 29(4): 798-807, 2022 12.
Article in English | MEDLINE | ID: covidwho-1640922

ABSTRACT

The current study aimed at exploring the relationship between objective disability, illness perceptions, resilience, fear of COVID-19, and psychological distress (i.e., anxiety, depression, and stress) in people with multiple sclerosis (pwMS) during the second wave of the COVID-19 outbreak. A group of 122 pwMS recruited in an Italian university hospital took part in this cross-sectional monocentric study. Hierarchical multiple linear regression analyses were performed to assess the strength of the hypothesized associations. Results indicated that, differently from cognitive impairment, motor disability was positively associated with anxiety. However, accounting for subjective illness perception, such association was no longer significant. Moreover, accounting for both protective and risk factors in the models, even illness perception was no longer significant, highlighting the central role of resilience and fear of COVID-19 in explaining the negative emotional outcomes. Implications for clinical interventions and psychoeducational trainings are discussed.


Subject(s)
COVID-19 , Disabled Persons , Motor Disorders , Multiple Sclerosis , Humans , Mental Health , SARS-CoV-2 , Multiple Sclerosis/complications , Multiple Sclerosis/epidemiology , Cross-Sectional Studies , Motor Disorders/epidemiology , Fear/psychology , Disease Outbreaks , Anxiety/epidemiology , Anxiety/psychology , Depression/epidemiology , Depression/psychology
6.
Eur J Neurol ; 28(10): 3375-3383, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1604393

ABSTRACT

BACKGROUND AND PURPOSE: In multiple sclerosis (MS), disease-related factors and dysfunctional coping might favor the development of mental distress induced by COVID-19 containment measures. Aim of this study was exploring the relationship between disability, coping strategies, daily life reorganization and neuropsychiatric symptoms in an Italian MS population during the COVID-19 lockdown, in order to identify potentially modifiable factors that could inform clinical management of mental distress in people with MS. METHODS: We explored the relationship between mental distress, disability and coping strategies in the Italian MS population under lockdown. Structural equation modeling was applied to information collected via web survey to identify modifiable factors that could account for mental distress. RESULTS: A total of 845 participants (497 with MS and 348 controls) were included in the study. The MS group had higher scores than the control group for depression (p = 0.005), but not for anxiety, emotional dyscontrol or sleep disturbances. The structural equation modeling explained 74% of the variance observed in depression score. Within the model, three latent factors were characterized from measured variables: motor disability and cognitive dysfunction contributed to disability (ß = 0.509 and ß = 0.836; p < 0.001); positive attitude and exercise contributed to active attitude (ß = 0.386 and ß = 0.297; p < 0.001); and avoidance, social support and watching television contributed to passive attitude (ß = 0.301, ß = 0.243 and ß = 0.212; p < 0.001). With regard to the relationship between latent factors and their influence on depression, disability contributed to passive attitude (ß = 0.855; p < 0.001), while both passive and active attitude significantly influenced depression (ß = 0.729 and ß = -0.456; p < 0.001). CONCLUSION: As a practical implication of our model, favoring exercise would enhance active attitude and its positive impact on mental well-being while, at the same time, reducing the negative impact of disability on depression, representing a valuable tool in facing COVID-19-related mental distress.


Subject(s)
COVID-19 , Disabled Persons , Motor Disorders , Multiple Sclerosis , Anxiety , Communicable Disease Control , Depression/epidemiology , Humans , Multiple Sclerosis/epidemiology , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
8.
J Clin Med ; 10(6)2021 Mar 16.
Article in English | MEDLINE | ID: covidwho-1136516

ABSTRACT

Physical disability impacts psychosocial wellbeing in people with multiple sclerosis. However, the role of physical activity in this context is still debated. By taking advantage of a previous survey, conducted online from 22 April to 7 May 2020, we performed a post-hoc analysis with the aim to assess the associations between disability, physical exercise, and mental health in multiple sclerosis. We retrieved the following data: (i) sociodemographic information, (ii) changes in lifestyle (including exercise), (iii) physical disability, as measured with the Patient-Determined Disease Steps scale, and (iv) anxiety feelings and depressive symptoms assessed via the items included in the Quality of Life in Neurological Disorders measurement system. Examination of the interaction plot showed that the effect of disability on depression, but not on anxious symptoms, was significant for all levels of physical exercise (low: b = 1.22, 95% C.I. 0.85, 1.58, p < 0.001; moderate: b = 0.95, 95% C.I. 0.66, 1.24, p < 0.001; and high: b = 0.68, 95% C.I. 0.24, 1.13, p = 0.003). Based on these data, we can conclude that disability significantly impacted depression during the COVID-19 pandemic, with physical activity playing a moderating role. Our results suggest that favoring exercise in multiple sclerosis (MS) would ameliorate psychological wellbeing regardless of the level of physical disability.

10.
J Clin Med ; 9(12)2020 Dec 16.
Article in English | MEDLINE | ID: covidwho-1024590

ABSTRACT

BACKGROUND: We compared the prevalence of SARS-CoV-2 IgG/IgM in multiple sclerosis (MS), low-risk, and high-risk populations and explored possible clinical correlates. METHODS: In this cross-sectional study, we recruited MS patients, low-risk (university staff from non-clinical departments), and high-risk individuals (healthcare staff from COVID-19 wards) from 11 May to 15 June 2020. We used lateral flow immunoassay to detect SARS-CoV-2 IgG and IgM. We used t-test, Fisher's exact test, chi square test, or McNemar's test, as appropriate, to evaluate between-group differences. RESULTS: We recruited 310 MS patients (42.3 ± 12.4 years; females 67.1%), 862 low-risk individuals (42.9 ± 13.3 years; females 47.8%), and 235 high-risk individuals (39.4 ± 10.9 years; females 54.5%). The prevalence of SARS-CoV-2 IgG/IgM in MS patients (n = 9, 2.9%) was significantly lower than in the high-risk population (n = 25, 10.6%) (p < 0.001), and similar to the low-risk population (n = 11, 1.3%) (p = 0.057); these results were also confirmed after random matching by age and sex (1:1:1). No significant differences were found in demographic, clinical, treatment, and laboratory features. Among MS patients positive to SARS-CoV-2 IgG/IgM (n = 9), only two patients retrospectively reported mild and short-lasting COVID-19 symptoms. CONCLUSIONS: MS patients have similar risk of SARS-CoV-2 infection to the general population, and can be asymptomatic from COVID-19, also if using treatments with systemic immunosuppression.

11.
Mult Scler Relat Disord ; 45: 102452, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-713197

ABSTRACT

BACKGROUND: The use of disease-modifying therapies (DMTs) in multiple sclerosis (MS) could affect COVID-19 outcomes by modulating the immune response, which, in turn, might favor viral replication and/or confer protection from COVID-19 induced inflammatory response CASE REPORT: We report on two MS patients treated with cladribine, with heterogeneous demographics and clinical features, who developed mild or no symptoms from COVID-19 and produced anti-SARS-CoV-2 antibodies, notwithstanding low lymphocyte levels. IMPLICATIONS: Benign COVID-19 clinical course and anti-SARS-CoV-2 antibody production can occur in MS patients with lymphopenia, suggesting the possibility to respond to COVID-19 vaccination, once available, in this vulnerable population.


Subject(s)
Cladribine/therapeutic use , Coronavirus Infections/immunology , Immunocompromised Host , Immunosuppressive Agents/therapeutic use , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Pneumonia, Viral/immunology , Adult , Antibodies, Viral/blood , Betacoronavirus/immunology , COVID-19 , Female , Humans , Male , Middle Aged , Multiple Sclerosis, Relapsing-Remitting/complications , Pandemics , SARS-CoV-2
12.
Telemed J E Health ; 26(12): 1533-1536, 2020 12.
Article in English | MEDLINE | ID: covidwho-646707

ABSTRACT

Introduction: With the spread of the SARS-CoV2 pandemic, telemedicine has become the safest way to guarantee care continuity, especially for chronic disabling diseases requiring frequent medical consultations and therapeutic adjustments, such as Parkinson's disease (PD). The age-related prevalence of PD, combined with increased vulnerability due to age-related comorbidities, makes PD patients protection a priority. Methodology: We reviewed potentials and limitations of teleneurology in PD and suggested a specific battery of tests, including patient-reported outcomes, smartphone applications, and neurological examination through telemedicine. Conclusions: These tools can provide full neurological consultations, with the engagement of both patients and caregivers, and can support clinicians in defining whether patients need to access diagnostic and therapeutic procedures. Telemedicine will also carry a value in the future, within conventional health care, to support clinicians in decision making, enabling more efficacious follow-up, reducing burden for caregivers, and delivering neurological expertise to local realities. These advantages are very important when there is physical distance between patients and neurologists, and when patients are not recommended to attend in-person consultations.


Subject(s)
COVID-19 , Continuity of Patient Care/standards , Needs Assessment/standards , Pandemics , Parkinson Disease/diagnosis , Parkinson Disease/therapy , Telemedicine/methods , Telemedicine/standards , Adult , Aged , Aged, 80 and over , Continuity of Patient Care/statistics & numerical data , Female , Humans , Italy , Male , Middle Aged , Needs Assessment/statistics & numerical data , Practice Guidelines as Topic , SARS-CoV-2 , Telemedicine/statistics & numerical data
13.
Neurol Sci ; 41(6): 1369-1371, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-616666

ABSTRACT

BACKGROUND: As a consequence of the coronavirus disease 2019 (COVID-19) pandemic, a large amount of consultations will be delivered through tele-medicine, especially for diseases causing chronic disability and requiring immunomodulatory treatments, such as multiple sclerosis (MS). METHODS: We have hereby reviewed available tools for tele-neurology examination in MS, including components of neurological examination that can be assessed through video, patient-reported outcome measures (PROMs), and digital technology. RESULTS: Overall, we have suggested a battery for assessing MS disability and relapses on tele-medicine, which brings together conventional examination, PROMs (e.g., Patient Determined Disease Steps, MS Impact Scale), and cognitive tests (Symbol Digit Modalities Test) that can be delivered remotely and in multiple languages. DISCUSSION: The use of common tools for neurological examination could improve tele-neurology practice for both general neurologists and MS specialists, and quality of care for people with MS.


Subject(s)
Disability Evaluation , Multiple Sclerosis, Relapsing-Remitting/epidemiology , Multiple Sclerosis, Relapsing-Remitting/therapy , Neurology/methods , Telemedicine/methods , Betacoronavirus , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Humans , Multiple Sclerosis/diagnosis , Multiple Sclerosis/epidemiology , Multiple Sclerosis/therapy , Multiple Sclerosis, Relapsing-Remitting/diagnosis , Neurology/trends , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , SARS-CoV-2 , Telemedicine/trends
14.
Mult Scler Relat Disord ; 44: 102282, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-592342

ABSTRACT

BACKGROUND: We hereby report on our experience from Naples (South Italy), where the peak of coronavirus disease 2019 (COVID-19) has already passed. METHODS: Assuming that COVID-19 will be circulating until vaccination and/or herd immunity is achieved (possibly not earlier than 2021), we have developed a protocol for the long-term management of multiple sclerosis (MS). RESULTS: We have defined a pathway for the access to the MS Centre with logistic, preventative and clinical recommendations, and have also included 14-day self-isolation and COVID-19 testing before some disease modifying treatments. DISCUSSION: Overall, we believe our experience could be helpful for MS management in the upcoming months.


Subject(s)
COVID-19/prevention & control , Multiple Sclerosis/therapy , COVID-19/complications , COVID-19 Testing , Disease Management , Humans , Italy , Multiple Sclerosis/complications
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