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Accelerated Course of Cerebral Adrenoleukodystrophy After Coronavirus Disease 2019 Infection
Qiu-Hong Wang1, Jing Wang1, Yang-Yang Wang1
1Medical School of Chinese PLA, Department of Pediatrics, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
Insights
COVID-19 infection can worsen neurological symptoms in boys with cerebral adrenoleukodystrophy (ALD). Protecting ALD patients from COVID-19 is crucial to prevent disease acceleration and maintain stability.
Area of Science:
- Neurology
- Infectious Diseases
- Genetics
Background:
- COVID-19 impacts the nervous system via inflammatory factors.
- Investigating COVID-19's effect on cerebral adrenoleukodystrophy (ALD).
Purpose of the Study:
- To analyze the impact of COVID-19 infection on neurological symptoms in cerebral ALD patients.
Main Methods:
- Retrospective analysis of 17 male cerebral ALD patients from Jan 2022-Feb 2023.
- Assessed changes in neurological symptoms using the Neurologic Function Scale (NFS).
Main Results:
- 64.7% of patients showed worsened neurological symptoms post-COVID-19.
- Patients not yet with major functional disabilities (MFDs) experienced NFS score increases.
- No COVID-19 related deaths were reported.
Conclusions:
- COVID-19 infection may accelerate cerebral ALD progression, especially in patients without MFDs.
- Preventing COVID-19 infection is vital for managing cerebral ALD stability.
Background:
Coronavirus disease 2019 (COVID-19) can not only infect the respiratory system but also affect the nervous system through the release of inflammatory factors. Our study aimed to investigate the effect of COVID-19 infection on cerebral adrenoleukodystrophy (ALD).
Methods:
Changes in the neurological symptoms of cerebral ALD after infection with COVID-19 from January 2022 to February 2023 were retrospectively analyzed. The primary assessment indicator was the Neurologic Function Scale (NFS) score.
Results:
A total of 17 male patients with cerebral ALD were enrolled, with a median age of 101 months (80 to 151 months). Among them, 11 (11 of 17, 64.7%) developed an exacerbation of neurological symptoms after COVID-19 infection. Two patients with NFS = 0 started presenting with neurological symptoms after infection. Fifteen patients were in the advanced stage (NFS >1 and/or Loes score >9), of which nine did not progress to major functional disabilities (MFDs). Seven of the nine patients (77.8%) experienced an increase in NFS scores, ranging from 1 to 9 points, within two weeks of COVID-19 infection, with four of them experiencing MFDs. For the other six patients who had progressed to MFDs, there was not much room for further degeneration, so the NFS score did not increase after COVID-19 infection. No deaths related to COVID-19 infection occurred.
Conclusions:
COVID-19 infection may aggravate neurological symptoms of cerebral ALD, particularly among patients who have not yet progressed to MFDs. Therefore, COVID-19 may accelerate the course of cerebral ALD, so protecting patients from infection is essential for maintaining the stability of the disease.
