COVID-19 and disease-modifying therapies in patients with demyelinating diseases of the central nervous system: A systematic review.
COVID-19 and disease-modifying therapies in patients with demyelinating diseases of the central nervous system: A systematic review.
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DOI：
10.1016/j.msard.2021.102800
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发表时间：
2021-05
影响因子：
4
通讯作者：
Giacomini PS
中科院分区：
文献类型：
--
作者：
Sharifian-Dorche M;Sahraian MA;Fadda G;Osherov M;Sharifian-Dorche A;Karaminia M;Saveriano AW;La Piana R;Antel JP;Giacomini PS
新型冠状病毒病（COVID-19）疫情继续在全球蔓延。这一流行病对慢性病患者产生了重大影响。在患有中枢神经系统（CNS）脱髓鞘疾病的患者中，如多发性硬化症（MS）或视神经肌病谱系障碍（NMOSD），人们仍然担心COVID-19对这些接受免疫抑制或免疫调节治疗的患者的潜在影响。在这项研究中，我们回顾了现有文献，调查了疾病修饰疗法（DMT）对这组患者COVID-19风险的影响。对于本系统性综述，我们检索了2020年1月1日至2020年12月3日的PubMed。使用了以下关键词：“COVID-19”和“多发性硬化症”或“视神经肌病”。纳入了评价CNS脱髓鞘疾病患者中COVID-19的文章。这项研究评估了COVID-19时代这些患者的DMT的不同方面。共检索到262篇文献，剔除重复和不相关的研究论文后，共有84篇文献符合本研究的最终纳入标准。总体而言，2493例MS患者和37例NMOSD患者的COVID-19经验纳入本综述。其中，46例（1.8%）MS患者死亡（据报告，全球新冠肺炎死亡病例比约为2.1%）。在DMT中，利妥昔单抗的死亡率最高（4%）。尽管存在争议，特别是关于抗CD 20单克隆抗体疗法，但许多研究并未发现DMT使用与COVID-19病程之间的关系。这一观察结果强化了不停止现有DMT的建议。其他变量，如年龄、较高的扩展残疾状态量表（EDSS）评分、心脏合并症和肥胖是严重COVID-19的独立风险因素。尽管存在感染风险，但大多数患者愿意在大流行期间继续接受DMT治疗，因为他们更担心MS症状复发或恶化的风险。感染后，Fingolimod和抗CD 20单克隆抗体患者的免疫应答减弱。这可能是未来疫苗接种的关键发现。
The Coronavirus disease-19 (COVID-19) pandemic continues to expand across the world. This pandemic has had a significant impact on patients with chronic diseases. Among patients with demyelinating diseases of the central nervous system (CNS), such as Multiple Sclerosis (MS) or Neuromyelitis Optica Spectrum Disorder (NMOSD), concerns remain about the potential impact of COVID-19 on these patients given their treatment with immunosuppressive or immunomodulatory therapies. In this study, we review the existing literature investigating the impact of disease-modifying therapies(DMT) on COVID-19 risks in this group of patients. For this systematic review, we searched PubMed from January 1, 2020, to December 3, 2020. The following keywords were used: “COVID-19” AND “Multiple Sclerosis” OR “Neuromyelitis Optica.” Articles evaluating COVID-19 in patients with demyelinating diseases of CNS were included. This study evaluates the different aspects of the DMTs in these patients during the COVID-19 era. A total of 262 articles were found. After eliminating duplicates and unrelated research papers, a total of 84 articles met the final inclusion criteria in our study. Overall, the experiences of 2493 MS patients and 37 NMOSD patients with COVID-19 were included in this review. Among them, 46(1.8%) MS patients died(the global death-to-case ratio of Covid-19 was reported about 2.1%). Among DMTs, Rituximab had the highest mortality rate (4%). Despite controversies, especially concerning anti-CD20 monoclonal antibody therapies, a relation between DMT-use and COVID-19 disease- course was not found in many studies. This observation reinforces the recommendation of not stopping current DMTs. Other variables such as age, higher expanded disability status scale (EDSS) scores, cardiac comorbidities, and obesity were independent risk factors for severe COVID-19. Despite the risks of infection, most patients were willing to continue their DMT during the pandemic because of more significant concern about the risk of relapse or worsening MS symptoms. After the infection, an immune response's attenuation was seen in the patients on Fingolimod and anti-CD20 monoclonal antibodies. This may be a critical finding in future vaccinations.
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影响因子：
1.4
作者：
DEMIR, Caner Feyzi;BILEK, Furkan;BALGETIR, Ferhat
通讯作者：
BALGETIR, Ferhat
DOI：
10.1016/j.medcle.2020.06.017
发表时间：
2020-10-23
期刊：
Medicina clinica (English ed.)
影响因子：
--
作者：
Castillo Álvarez F;López Pérez MÁ;Marzo Sola ME
通讯作者：
Marzo Sola ME
影响因子：
5.8
作者：
Dersch, Rick;Wehrum, Thomas;Berger, Benjamin
通讯作者：
Berger, Benjamin
影响因子：
3.3
作者：
Ciardi, Maria Rosa;Zingaropoli, Maria Antonella;Mastroianni, Claudio Maria
通讯作者：
Mastroianni, Claudio Maria
影响因子：
6
作者：
Capuano, Rocco;Altieri, Manuela;Gallo, Antonio
通讯作者：
Gallo, Antonio