Outcomes of coronavirus disease 2019 in patients with neuromyelitis optica and associated disorders
Outcomes of coronavirus disease 2019 in patients with neuromyelitis optica and associated disorders
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DOI：
10.1111/ene.14612
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发表时间：
2020-11-27
影响因子：
5.1
通讯作者：
De Seze, Jerome
中科院分区：
文献类型：
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作者：
Louapre, Celine;Maillart, Elisabeth;De Seze, Jerome
背景2019冠状病毒病（COVID-19）在视神经脊髓炎谱系障碍（NMOSD）或髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）患者中的结局仍然未知，这些患者通常接受免疫抑制治疗。方法：我们在法国所有视神经脊髓炎及相关疾病专家中心进行了一项多中心、回顾性、观察性队列研究。纳入研究的NMOSD或MOGAD患者在2020年3月1日至2020年6月30日期间被确诊或高度疑似诊断为COVID-19。主要结局是COVID-19严重程度评分，按7分顺序进行评估，从1（未住院，无活动限制）到7（死亡）。结果15例患者（平均[SD]年龄：39.3[14.3]岁，女性11例）。5例患者（33.3%）住院，均接受利妥昔单抗治疗。患者24岁，水通道蛋白-4抗体阳性，合并肥胖，需机械通气。门诊患者分别接受抗cd20(5)、霉酚酸酯(3)或硫唑嘌呤(3)治疗。他们较年轻（平均[SD]年龄：37.0[13.4]岁），病程较长（平均[SD]: 8.3[6.3]年），相对于需要住院治疗的患者（平均[SD]年龄：44.0[16.4]岁，平均[SD]病程：5.8[5.5]年，中位数[范围]EDSS: 4[0-6.5]），扩展残疾严重程度评分（EDSS）评分较低（中位数[范围]EDSS: 2.5[0-4]）。结论：在该队列中，COVID-19的结局总体有利。需要开展更大规模的国际研究，以确定严重COVID-19的风险因素；然而，我们建议采取个人防护措施，以降低免疫功能低下人群感染SARS-CoV-2的风险。
Background Outcomes of coronavirus disease 2019 (COVID-19) in patients with neuromyelitis optica spectrum disorders (NMOSD) or myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), often treated with immunosuppressive therapies, are still unknown.Methods We conducted a multicenter, retrospective, observational cohort study among all French expert centers for neuromyelitis optica and related disorders. Patients with NMOSD or MOGAD included in the study received a confirmed or highly suspected diagnosis of COVID-19 between 1 March 2020 and 30 June 2020. Main outcome was COVID-19 severity score assessed on a seven-point ordinal scale ranging from 1 (not hospitalized with no limitations on activities) to 7 (death).Results Fifteen cases (mean [SD] age: 39.3 [14.3] years, 11 female) were included. Five patients (33.3%) were hospitalized, all receiving rituximab. A 24-year-old patient with positive aquaporine-4 antibody, with obesity as comorbidity, needed mechanical ventilation. Outpatients were receiving anti-CD20 (5), mycophenolate mofetil (3) or azathioprine (3). They were younger (mean [SD] age: 37.0 [13.4] years), with a longer disease duration (mean [SD]: 8.3 [6.3] years) and had a lower expanded disability severity score (EDSS) score (median [range] EDSS: 2.5 [0-4]) relative to patients requiring hospitalization (mean [SD] age: 44.0 [16.4] years, mean [SD] disease duration: 5.8 [5.5] years, median [range] EDSS: 4 [0-6.5]).Conclusions COVID-19 outcome was overall favorable in this cohort. Larger international studies are needed to identify risk factors of severe COVID-19; however, we recommend personal protective measures to reduce risk of SARS-CoV-2 infection in this immunocompromised population.