Document Type: Original Article

Authors

1 Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 School of Medicine, Yazd University of Medical Sciences, Yazd, Iran

Abstract

Background: Despite many studies, it is still unclear how patients with neuromyelitis optica spectrum disorder (NMOSD) would respond to coronavirus disease 2019 (COVID-19). We conducted a research on prevalence of COVID-19 in patients with NMOSD in Isfahan, Iran. We have also reviewed the recent publications on this issue.
Methods: 149 patients with NMOSD who were under medications were monitored for confirmed cases of COVID-19. Prevalence of COVID-19 in addition to mean age, mean duration of disease, and mean age of onset of infected patients and uninfected patients were calculated via Microsoft Excel software.
Results: The prevalence of COVID-19 in studied patients with NMOSD was 5.37%. Mean age, mean duration of disease, and mean age of onset of eight patients (male to female ratio: 1:3) diagnosed with COVID-19 were 33.62 ± 5.20 years, 6.87 ± 6.05 years, and 26.75 ± 6.94 years, respectively, while they were 39.97 ± 11.37 years, 7.50 ± 3.91 years, and 32.46 ± 11.29 years for uninfected patients with NMOSD (n = 141). No significant association was observed between the type of medications and prevalence of COVID-19 (P > 0.05).
Conclusion: There is not a consensus in the literature on the prevalence of COVID-19 in patients with NMOSD and the effect of NMOSD medications on susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The prevalence of COVID-19 in our sample was 5.37%. The impact of the kind of NMOSD medication on the prevalence of COVID-19 in patients with NMOSD was found to be insignificant. Moreover, the infected patients were relatively younger, and their disease started earlier in comparison to uninfected patients.

Keywords

  1. Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of underlying diseases in hospitalized patients with COVID-19: A systematic review and meta-analysis. Arch Acad Emerg Med 2020; 8(1): e35.
  2. Fung M, Babik JM. COVID-19 in Immunocompromised hosts: What we know so far. Clin Infect Dis 2021; 72(2): 340-50.
  3. Wu Y, Zhong L, Geng J. Neuromyelitis optica spectrum disorder: Pathogenesis, treatment, and experimental models. Mult Scler Relat Disord 2019; 27: 412-8.
  4. Chang VTW, Chang HM. Review: Recent advances in the understanding of the pathophysiology of neuromyelitis optica spectrum disorder. Neuropathol Appl Neurobiol 2020; 46(3): 199-218.
  5. Hor JY, Asgari N, Nakashima I, Broadley SA, Leite MI, Kissani N, et al. Epidemiology of neuromyelitis optica spectrum disorder and its prevalence and incidence worldwide. Front Neurol 2020; 11: 501.
  6. Zephir H. Progress in understanding the pathophysiology of multiple sclerosis. Rev Neurol (Paris) 2018; 174(6): 358-63.
  7. Eskandarieh S, Nedjat S, Azimi AR, Moghadasi AN, Sahraian MA. Neuromyelitis optica spectrum disorders in Iran. Mult Scler Relat Disord 2017; 18: 209-12.
  8. Creed MA, Ballesteros E, Jr LJG, Imitola J. Mild COVID-19 infection despite chronic B cell depletion in a patient with aquaporin-4-positive neuromyelitis optica spectrum disorder. Mult Scler Relat Disord 2020; 44: 102199.
  9. Paz SPC, Branco L, Pereira MAC, Spessotto C, Fragoso YD. Systematic review of the published data on the worldwide prevalence of John Cunningham virus in patients with multiple sclerosis and neuromyelitis optica. Epidemiol Health 2018; 40: e2018001.
  10. Masuda S, Mori M, Arai K, Uzawa A, Muto M, Uchida T, et al. Epstein-Barr virus persistence and reactivation in neuromyelitis optica. J Neurol Neurosurg Psychiatry 2015; 86(10): 1137-42.
  11. Mori M, Hosoya M, Hiwasa T, Hayakawa S, Uzawa A, Kuwabara S. Detection of mumps virus RNA in cerebrospinal fluid of patients with neuromyelitis optica. Neurol Sci 2011; 32(5): 795-9.
  12. Rezaei SJ, Vogel AC, Gazdag B, Alakel N, Kumar AR, Mateen FJ. Neuromyelitis optica practice and prescribing changes in the setting of Covid19: A survey of neurologists. J Neuroimmunol 2020; 346: 577320.
  13. Ricardo A, Carnero CE, Anabel SB, Adrian LP, Orlando G, Fernando H, et al. Decision-making on management of ms and nmosd patients during the COVID-19 pandemic: A latin american survey. Mult Scler Relat Disord 2020; 44: 102310.
  14. Abboud H, Zheng C, Kar I, Chen CK, Sau C, Serra A. Current and emerging therapeutics for neuromyelitis optica spectrum disorder: Relevance to the COVID-19 pandemic. Mult Scler Relat Disord 2020; 44: 102249.
  15. Hamdy SM, Abdel-Naseer M, Shehata HS, Shalaby NM, Hassan A, Elmazny A, et al. Management strategies of patients with neuromyelitis optica spectrum disorder during the COVID-19 pandemic era. Ther Clin Risk Manag 2020; 16: 759-67.
  16. Tomczak A, Han MH. The impact of COVID-19 on patients with neuromyelitis optica spectrum disorder; a pilot study. Mult Scler Relat Disord 2020; 45: 102347.
  17. Fan M, Qiu W, Bu B, Xu Y, Yang H, Huang D, et al. Risk of COVID-19 infection in MS and neuromyelitis optica spectrum disorders. Neurol Neuroimmunol Neuroinflamm 2020; 7(5): e787.
  18. Sahraian MA, Azimi A, Navardi S, Rezaeimanesh N, Naser MA. Evaluation of COVID-19 infection in patients with Neuromyelitis optica spectrum disorder (NMOSD): A report from Iran. Mult Scler Relat Disord 2020; 44: 102245.
  19. Mirmosayyeb O, Vaheb S, Barzegar M, Shaygannejad V, Bonavita S, Ghajarzadeh M. Screening neuromyelitis optica patients for COVID-19 infection. Autoimmun Rev 2020; 19(11): 102669.
  20. Zeidan S, Maillart E, Louapre C, Roux T, Lubetzki C, Papeix C. COVID-19 infection in NMO/SD patients: A French survey. J Neurol 2021; 268(4): 1188-90.
  21. Meca-Lallana V, Aguirre C, Beatrizdel R, Cardenoso L, Alarcon T, Vivancos J. COVID-19 in 7 multiple sclerosis patients in treatment with ANTI-CD20 therapies. Mult Scler Relat Disord 2020; 44: 102306.
  22. Rostami MS, Ghasemi-Kasman M. Impact of disease-modifying drugs on the severity of COVID-19 infection in multiple sclerosis patients. J Med Virol 2021; 93(3): 1314-9.
  23. Etemadifar M, Aghababaee A, Sedaghat N, Rayani M, Nouri H, Abhari A, et al. WITHDRAWN: Incidence and mortality of COVID-19 in Iranian multiple sclerosis patients treated with disease-modifying therapies. Rev Neurol (Paris) 2020. [Epub ahead of print.].
  24. Ciampi E, Uribe-San-Martin R, Soler B, Fernandez R, Garcia P, Navarrete-Asenjo C, et al. COVID-19 in MS and NMOSD: A multicentric online national survey in Chile. Mult Scler Relat Disord 2020; 45: 102392.
  25. Mantero V, Rigamonti A, Basilico P, Crespi M, Balgera R, Salmaggi A. Mild COVID-19 infection in an NMO patient treated with tocilizumab: A confirmation of anti-IL-6 protective role? J Neurol 2020; 267(12): 3465-6.
  26. Aziz M, Fatima R, Assaly R. Elevated interleukin-6 and severe COVID-19: A meta-analysis. J Med Virol 2020; 92(11): 2283-5.
  27. Perrone F, Piccirillo MC, Ascierto PA, Salvarani C, Parrella R, Marata AM, et al. Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial. J Transl Med 2020; 18(1): 405.
  28. Mariajoseph-Antony LF, Kannan A, Panneerselvam A, Loganathan C, Anbarasu K, Prahalathan C. Could aquaporin modulators be employed as prospective drugs for COVID-19 related pulmonary comorbidity? Med Hypotheses 2020; 143: 110201.
  29. Baker D, Roberts CAK, Pryce G, Kang AS, Marta M, Reyes S, et al. COVID-19 vaccine-readiness for anti-CD20-depleting therapy in autoimmune diseases. Clin Exp Immunol 2020; 202(2): 149-61.
  30. Houot R, Levy R, Cartron G, Armand P. Could anti-CD20 therapy jeopardise the efficacy of a SARS-CoV-2 vaccine? Eur J Cancer 2020; 136: 4-6.