COVID-19 en pacientes con esclerosis múltiple: estudio observacional retrospectivo en un centro de referencia colombiano
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Palabras clave

Esclerosis Múltiple
COVID-19
SARS-CoV-2
Vacunas COVID-19
Infección irruptiva COVID-19
Terapia Inmunosupresora

Resumen

Introducción: en Colombia, la información sobre la frecuencia de presentación de la enfermedad por COVID-19 y sus desenlaces en personas con esclerosis múltiple (EM) es prácticamente inexistente. El objetivo de este estudio es describir la frecuencia, las características y los factores relacionados con la infección por COVID-19 en una muestra de pacientes con EM en Colombia.

Materiales y métodos: análisis descriptivo y retrospectivo de pacientes diagnosticados con criterios de esclerosis múltiple que acudieron a nuestro centro entre junio y octubre del año 2021. Los pacientes proporcionaron información sobre la infección por SARS-CoV-2 y su vacunación. Se analizaron los factores relacionados con la infección por COVID-19 mediante modelos de regresión logística binomial uni y multivariable.

Resultados: se analizaron 240 pacientes, de los cuales el 71?% eran mujeres, con una edad promedio de 34 años. La mayoría estaban en tratamiento con terapias modificadoras de la enfermedad y más del 80?% estaban vacunados. Sesenta y nueve pacientes declararon haber tenido COVID-19. En los modelos multivariables, la edad (OR 0,96; IC 95?% 0,93-0,99) fue el único factor asociado con una menor probabilidad de infección por COVID-19.

Discusión: la infección por COVID-19 en pacientes con EM en Colombia parece ser independiente de las variables clínicas y de tratamiento y parece estar asociada con la menor edad.

Conclusiones: se requieren más estudios para evaluar el comportamiento del COVID-19 en pacientes con EM en el contexto colombiano.

https://doi.org/10.22379/anc.v39i2.1446

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Tur C, Dubessy A-L, Otero-Romero S, Amato MP, Derfuss T, Di Pauli F, et al. The risk of infections for multiple sclerosis and neuromyelitis optica spectrum disorder disease-modifying treatments: Eighth European Committee for Treatment and Research in Multiple Sclerosis Focused Workshop Review. Mult Scler. 2022;28:1424–56. https://doi.org/10.1177/13524585211069068

Louapre C, Collongues N, Stankoff B, Giannesini C, Papeix C, Bensa C, et al. Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis. JAMA Neurol. 2020;77:1079. https://doi.org/10.1001/jamaneurol.2020.2581

Moreno-Torres I, Meca Lallana V, Costa-Frossard L, Oreja-Guevara C, Aguirre C, Alba Suárez EM, et al. Risk and outcomes of COVID-19 in patients with multiple sclerosis. Eur J Neurol. 2021;28:3712–21. https://doi.org/10.1111/ene.14990

Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. Journal of Infection. 2020;81:e16–25. https://doi.org/10.1016/j.jinf.2020.04.021

Bsteh G, Bitschnau C, Hegen H, Auer M, Di Pauli F, Rommer P, et al. Multiple sclerosis and COVID-19: how many are at risk? Eur J Neurol. 2021;28:3369-3374. https://doi.org/10.1111/ene.14555

Chaudhry F, Bulka H, Rathnam AS, Said OM, Lin J, Lorigan H, et al. COVID-19 in multiple sclerosis patients and risk factors for severe infection. J Neurol Sci. 2020;418:117147. https://doi.org/10.1016/j.jns.2020.117147

Zuluaga-Rodas M, Orozco-Gonzalez C, Ortiz-Salas P, Vagner B, Gortari J, Camacho-Barbosa J, et al. COVID-19 in patients with multiple sclerosis and neuromyelitis optica spectrum disorder in Colombia. Mult Scler J. 2021;27:235–6.

Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162–73. https://doi.org/10.1016/S1474-4422(17)30470-2

Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278–86. https://doi.org/10.1212/WNL.0000000000000560

Kurtzke J. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33:1444–52. https://doi.org/10.1212/wnl.33.11.1444

Laroni A, Schiavetti I, Sormani MP, Uccelli A. COVID-19 in patients with multiple sclerosis undergoing disease-modifying treatments. Mult Scler. 2021; 27:2126–36. https://doi.org/10.1177/1352458520971817

Hada M, Mosholder AD, Leishear K, Perez-Vilar S. Systematic review of risk of SARS-CoV-2 infection and severity of COVID-19 with therapies approved to treat multiple sclerosis. Neurol Sci. 2022;43:1557–67. https://doi.org/10.1007/s10072-021-05846-3

Sormani MP, De Rossi N, Schiavetti I, Carmisciano L, Cordioli C, Moiola L, et al. Disease?Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis. Ann Neurol. 2021;89:780–9. https://doi.org/10.1002/ana.26028

Sormani MP, Salvetti M, Labauge P, Schiavetti I, Zephir H, Carmisciano L, et al. DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France. Ann Clin Transl Neurol. 2021;8:1738–44. https://doi.org/10.1002/acn3.51408

Simpson-Yap S, De Brouwer E, Kalincik T, Rijke N, Hillert JA, Walton C, et al. Associations of Disease-Modifying Therapies With COVID-19 Severity in Multiple Sclerosis. Neurology. 2021;97:e1870–85. https://doi.org/10.1212/WNL.0000000000012753

Strangfeld A, Schäfer M, Gianfrancesco MA, Lawson-Tovey S, Liew JW, Ljung L, et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2021;80:930–42. https://doi.org/10.1136/annrheumdis-2020-219498

Vijenthira A, Gong I, Betschel SD, Cheung M, Hicks LK. Vaccine response following anti-CD20 therapy: a systematic review and meta-analysis of 905 patients. Blood Adv. 2021;5:2624–43. https://doi.org/10.1182/bloodadvances.2021004629

Apostolidis SA, Kakara M, Painter MM, Goel RR, Mathew D, Lenzi K, et al. Cellular and humoral immune responses following SARS-CoV-2 mRNA vaccination in patients with multiple sclerosis on anti-CD20 therapy. Nat Med. 2021; 27:1990–2001. https://doi.org/10.1038/s41591-021-01507-2

Sullivan R, Kilaru A, Hemmer B, Campbell Cree BA, Greenberg BM, Kundu U, et al. COVID-19 Infection in Fingolimod- or Siponimod-Treated Patients. Neurol - Neuroimmunol Neuroinflammation. 2022;9:e1092. https://doi.org/10.1212/NXI.0000000000001092

Meyer-Arndt L, Braun J, Fauchere F, Vanshylla K, Loyal L, Henze L, et al. SARS-CoV-2 mRNA vaccinations fail to elicit humoral and cellular immune responses in patients with multiple sclerosis receiving fingolimod. J Neurol Neurosurg Psychiatry. 2022;93:960–71. https://doi.org/10.1136/jnnp-2022-329395

Tortorella C, Aiello A, Gasperini C, Agrati C, Castilletti C, Ruggieri S, et al. Humoral- and T-Cell–Specific Immune Responses to SARS-CoV-2 mRNA Vaccination in Patients With MS Using Different Disease-Modifying Therapies. Neurology. 2022;98:e541–54. https://doi.org/10.1212/WNL.0000000000013108

Zabalza A, Arrambide G, Otero-Romero S, Pappolla A, Tagliani P, López-Maza S, et al. Is humoral and cellular response to SARS-CoV-2 vaccine modified by DMT in patients with multiple sclerosis and other autoimmune diseases? Mult Scler. 2022;28:1138-1145. https://doi.org/10.1177/13524585221089540

Saraceno L, Susani EL, Marazzi MR, Moioli MC, Agostoni EC, Protti A. SARS-CoV-2 infection after alemtuzumab in a multiple sclerosis patient: milder disease symptoms in comparison with coinfected relatives: a case report and review of the literature. Neurol Sci. 2021;42:4881–4. https://doi.org/10.1007/s10072-021-05567-7

Matías-Guiu J, Montero-Escribano P, Pytel V, Porta-Etessam J, Matias-Guiu JA. Potential COVID-19 infection in patients with severe multiple sclerosis treated with alemtuzumab. Mult Scler Relat Disord. 2020;44:102297. https://doi.org/10.1016/j.msard.2020.102297

Peckham H, de Gruijter NM, Raine C, Radziszewska A, Ciurtin C, Wedderburn LR, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun.2020;11: 6317. https://doi.org/10.1038/s41467-020-19741-6

Abate BB, Kassie AM, Kassaw MW, Aragie TG, Masresha SA. Sex difference in coronavirus disease (COVID-19): a systematic review and meta-analysis. BMJ Open. 2020;10:e040129. https://doi.org/10.1136/bmjopen-2020-040129

Scalfari A, Neuhaus A, Daumer M, Ebers GC, Muraro PA. Age and disability accumulation in multiple sclerosis. Neurology. 2011;77:1246–52. https://doi.org/10.1212/WNL.0b013e318230a17d

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