多发性硬化症患者的COVID-19-A叙事审查
Bijay Kumar Shrestha1, Eru Sujakhu1, Smruti Karale2
1University of South Alabama Children's and Women's Hospital, Mobile, AL, United States.
Multiple sclerosis and related disorders
|December 15, 2024
概括
患有多发性硬化症 (MS) 的患者面临类似的COVID-19感染风险,但如果残疾,可能会出现严重的结果. 大多数疾病修饰疗法是安全的,但Rituximab增加了风险. 建议所有多发性硬化症患者接种COVID-19疫苗.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 多发性硬化症 (MS) 是一种神经退行性疾病,在全球影响超过250万,其特点是免疫调节失调.
- COVID-19可以通过脱髓化引起神经退行,类似于MS,并导致长期的神经问题.
- 重叠的机制表明MS和COVID-19之间存在独特的关系.
研究的目的:
- 探索COVID-19和多发性硬化症 (MS) 之间的关系.
- 评估COVID-19感染的风险和MS (PwMS) 患者的严重结果.
- 评估MS疾病修饰疗法 (DMT) 和疫苗接种对PwMS的COVID-19的影响.
主要方法:
- 审查有关COVID-19和MS的现有文献.
- 在PwMS中分析严重COVID-19的危险因素.
- 评估各种DMT对COVID-19结果和疫苗反应的影响.
主要成果:
- 普华永道MS与普通人群的COVID-19感染风险相似,但那些残疾较高,MS持续时间较长或MS进展较长的人面临更严重的结果.
- 大多数DMT (干扰素,格拉蒂拉美尔,特里弗卢诺米德,克拉迪宾) 不会影响COVID-19的风险,严重程度或疫苗反应,应该继续使用.
- 利图西马布增加了严重COVID-19结局的风险;雷姆迪西维尔和单克隆抗体是有效的治疗方法.
结论:
- COVID-19感染不会增加MS复发或疾病进展.
- 接种COVID-19疫苗是安全的,并建议所有多发性硬化症患者,特别是高危人群.
- 由于有限的高质量证据,需要进一步的研究来充分理解COVID-19和MS的关系.
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