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Published on: August 21, 2017
Clinical Features of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorders
Samira Luisa Apostolos-Pereira1, Lis Campos Ferreira1, Mateus Boaventura1
1From the Hospital das Clínicas (S.L.A., M.B., G.D.S., L.B., C.C.D.D., D.C.), FM-USP, São Paulo; Universidade Federal de Sergipe and Univ. Tiradentes (L.C.F.), Aracaju; Hospital Univ. Getúlio Vargas (N.A.d.C.S.), Manaus; Hospital Geral de Fortaleza (G.J.M., J.A.d.A., M.S.P., L.S.M.); Universidade Federal da Bahia/Ebserh (T.F.), Salvador; Hospital Ophir Loyola (H.L.S., L.C.R.), Belém; FUNAD (B.E.S.), João Pessoa; UNICAMP (C.R.A.), Campinas; Universidade Federal de São Paulo (E.M.L., L.d.S.A.), UNIFESP; Universidade Metropolitana de Santos (A.A.F.d.C., Y.D.F.); Santa Casa (A.P.G.), Belo Horizonte; Hospital da Restauração (M.I.d.M., A.J.P.), Recife; Santa Casa (R.P.C., M.F.M.), São Paulo; Hospital de Base do Distrito Federal (R.M.D.), Brasília; Hospital Santa Marcelina (A.C.P.), São Paulo; Private Service (A.K.), Cuiabá; Clínica AMO (A.M.), Salvador; Hospital Universitário Gaffree e Guinle (C.C.F.V.), Rio de Janeiro; Santa Casa (D.R.K.M.), Londrina; Universidade Federal de Goiás (D.S.D.), Goiânia; Private Service (E.R.C.-F.), Belo Horizonte; Faculdade de Medicina de Botucatu (F.C.G.D.R, D.G.B.), UNESP; Santa Casa and ABEM-Assoc. Brasileira de Esclerose Múltipla (G.S.d.O.), São Paulo; Universidade Estácio de Sá and Universidade Federal Fluminenses (G.A.C.), Rio de Janeiro; Universidade Federal Fluminense (H.H.R.), Campinas; Universidade Federal do Mato Grosso (H.H.S., J.A.F., L.S.), Cuiabá; Private Service (H.K.S.), Curitiba; IAMSPE (H.R.S.N.), São Paulo; Private Service (L.C.C.), São Paulo; Faculdade de Medicina de Marília (L.D.M.); Univ. da Região de Joinville (Univille) (M.V.M.G.); Santa Casa (M.L.V.P.), Rio de Janeiro; Univ. Federal R G Norte (M.E.T.D.), Natal; Univ. Federal Ciências da Saúde de Porto Alegre (M.d.C.R.); PUC (P.D.d.G.), Sorocaba; Hospital Israelita Albert Einstein (R.B.T.), São Paulo; Univ. Federal de Uberlândia (R.d.R.M.); Hospital Beneficência Portuguesa (S.G.), São Paulo; Hospital Memorial São José (S.S.), rede D'OR, Recife; Univ. Federal do Rio de Janeiro (S.N.M., V.C.S.R.P.); Private Service (S.N.M.), Florianópolis; Univ. Federal de Goiás (T.A.G.J.R.), Goiânia; Hospital Neurológico de Goiânia (V.M.C.); Pontifícia Universidade Católica de Campinas (M.M.d.M.P.); Hospital Universitário da Universidade Federal de Santa Catarina (A.W.d.N.J.), Florianópolis; Faculdade de Medicina de Ribeirão Preto (E.A.D.), USP; Hospital Sírio-Libanês (T.A.), São Paulo; and Faculty of Medicine (F.v.G.), University of Brasilia, Brazil.
Patients with neuromyelitis optica spectrum disorder (NMOSD) generally experienced mild COVID-19, but faced higher hospitalization risks. SARS-CoV-2 infection increased the likelihood of NMOSD relapses.
Area of Science:
- Neuroimmunology
- Infectious Diseases
- Clinical Medicine
Background:
- Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune condition affecting the central nervous system.
- The impact of coronavirus disease 2019 (COVID-19) on patients with NMOSD (pwNMOSD) requires detailed investigation.
Purpose of the Study:
- To characterize the clinical presentation and outcomes of COVID-19 in patients with NMOSD.
- To identify potential risk factors and complications associated with SARS-CoV-2 infection in this vulnerable population.
Main Methods:
- A nationwide registry (REDONE.br) collected data on pwNMOSD with confirmed or suspected COVID-19 in Brazil.
- Data included demographics, NMOSD characteristics, comorbidities, treatments, and COVID-19 clinical features and severity.
Main Results:
- Out of 2,061 pwNMOSD, 34 developed COVID-19; most had mild illness treated at home.
- However, pwNMOSD showed significantly higher rates of hospitalization and intensive care unit admission compared to the general population.
- Fifteen percent of patients experienced NMOSD-related neurologic events (relapse or pseudoexacerbation) during or after SARS-CoV-2 infection.
Conclusions:
- While most NMOSD patients had mild COVID-19, they faced elevated risks for severe outcomes and hospitalization.
- SARS-CoV-2 infection emerged as a significant risk factor for NMOSD relapses.
- Further collaborative research is essential to elucidate factors influencing COVID-19 severity and neurological manifestations in pwNMOSD.
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