Recovery From COVID-19 in Multiple Sclerosis: A Prospective and Longitudinal Cohort Study of the United Kingdom Multiple Sclerosis Register.
Recovery From COVID-19 in Multiple Sclerosis: A Prospective and Longitudinal Cohort Study of the United Kingdom Multiple Sclerosis Register.
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DOI：
10.1212/nxi.0000000000001118
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发表时间：
2022-01
期刊：
影响因子：
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通讯作者：
Evangelou N
中科院分区：
文献类型：
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作者：
Garjani A;Middleton RM;Nicholas R;Evangelou N
了解多发性硬化症 (MS) 患者从 2019 年冠状病毒病 (COVID-19) 中恢复的过程，并确定其预测因素，包括患者在 COVID-19 之前的身体和心理健康状况。作为英国 MS 登记册 (UKMSR) COVID-19 研究的一部分，这项前瞻性纵向队列研究招募了 2020 年 3 月 17 日至 2021 年 3 月 19 日报告过 COVID-19 的 MS 患者。参与者使用在线问卷定期更新他们的 COVID-19 症状、恢复状态以及完全康复者的症状持续时间。调查问卷带有日期标记，用于估计上次随访时尚未康复的人的 COVID-19 症状持续时间。 UKMSR 拥有参与者的人口统计和最新临床数据以及他们基于网络的扩展残疾状态量表 (web-EDSS) 和医院焦虑和抑郁量表 (HADS) 评分。使用多变量 Cox 回归分析评估这些因素与 COVID-19 恢复之间的关联。在参与 UKMSR COVID-19 研究的 7,977 名多发性硬化症患者中，有 599 名报告了 COVID-19 并前瞻性更新了他们的康复状态。二十八名住院参与者被排除在外。至少 165 名参与者 (29.7%) 患有长期 COVID-19 症状≥4 周，69 名参与者 (12.4%) 患有≥12 周。 COVID-19 前 web-EDSS 评分≥7 的参与者、COVID-19 发病前可能患有焦虑和/或抑郁（HADS 评分≥11）的参与者以及女性报告从 COVID-19 康复的可能性较小。 MS 患者会受到 COVID-19 急性后遗症的影响。先前存在的严重神经功能障碍或心理健康问题似乎会增加这种风险。这些发现可能对调整他们的 COVID-19 后康复具有重要意义。
To understand the course of recovery from coronavirus disease 2019 (COVID-19) among patients with multiple sclerosis (MS) and to determine its predictors, including patients' pre–COVID-19 physical and mental health status. This prospective and longitudinal cohort study recruited patients with MS who reported COVID-19 from March 17, 2020, to March 19, 2021, as part of the United Kingdom MS Register (UKMSR) COVID-19 study. Participants used online questionnaires to regularly update their COVID-19 symptoms, recovery status, and duration of symptoms for those who fully recovered. Questionnaires were date stamped for estimation of COVID-19 symptom duration for those who had not recovered at their last follow-up. The UKMSR holds demographic and up-to-date clinical data on participants as well as their web-based Expanded Disability Status Scale (web-EDSS) and Hospital Anxiety and Depression Scale (HADS) scores. The association between these factors and recovery from COVID-19 was assessed using multivariable Cox regression analysis. Of the 7,977 patients with MS who participated in the UKMSR COVID-19 study, 599 reported COVID-19 and prospectively updated their recovery status. Twenty-eight hospitalized participants were excluded. At least 165 participants (29.7%) had long-standing COVID-19 symptoms for ≥4 weeks and 69 (12.4%) for ≥12 weeks. Participants with pre–COVID-19 web-EDSS scores ≥7, participants with probable anxiety and/or depression (HADS scores ≥11) before COVID-19 onset, and women were less likely to report recovery from COVID-19. Patients with MS are affected by postacute sequelae of COVID-19. Preexisting severe neurologic impairment or mental health problems appear to increase this risk. These findings can have implications in tailoring their post–COVID-19 rehabilitation.