Background and objectives: Multiple sclerosis (MS) patients tend to present peculiar personality traits that highly impact their quality of life. Our study aimed to determine which personality traits are more common in MS patients compared to a sex- and age-matched control group. Methods and materials: Patients with relapsing–remitting MS along with a sex- and age-matched control group were included. All subjects completed the DECAS Personality Inventory and an additional form including demographic characteristics. Data (including descriptive statistics and univariate and multivariate analysis) were analyzed using SPSS. Results: 122 subjects were included, out of which 61 were in the patient group, mostly females (71.31%) with a mean age of 42.06 ± 10.46 years. Mean duration of disease was 10.18 ± 5.53 years and mean EDSS score was 2.09; 36% of patients were treated with Interferon-beta 1a. Subjects in the patient group presented significantly lower scores for extraversion (p = 0.036), specifically those with higher EDSS score, even after adjusting for possible confounders (age, sex, marital status, early retirement, alcohol, and tobacco consumption). Additionally, regarding orientation in life, MS patients were more often philosophers (p = 0.001), especially young males, whereas the dominant emotional feeling was less common, the actor profile (p = 0.022). Regarding task involvement, MS patients were often passive and compassionate concerning other people. Higher EDSS score also correlated with avoidant (p = 0.006) and melancholic (p = 0.043) personality traits. Subjects with higher education associated more often pragmatic, experimenter, popular, and optimist traits, whereas the elderly had actor, authoritarian, and experimenter profiles. Conclusions: Some MS patients may have reduced levels of extraversion and specific personality traits compared to age- and sex-matched subjects. Determining the exact personality profile might help the neurologist to establish a better therapeutic alliance and to apply specific interventions.

Introduction: The emerging Coronavirus Disease (COVID-19) pandemic caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a serious public health issue due to its rapid spreading, high mortality rate and lack of specific treatment. Given its unpredictable clinical course, risk assessment, and stratification for severity of COVID-19 are required. Apart from serving as admission criteria, prognostic factors might guide future therapeutic strategies.Aim: We aimed to compare clinical features and biological parameters between elderly (age ≥ 65 years) and non-elderly (age <65 years) patients with COVID-19 and new neurological symptoms/conditions. We also aimed to determine factors independently associated with all-cause in-hospital mortality.Methods: All consecutive patients with COVID-19 and new neurological symptoms/conditions admitted in our Neurology Department between April 1 and August 23, 2020 were enrolled in this observational retrospective cohort study. Patient characteristics such as demographic data, comorbidities, biological parameters, imaging findings and clinical course were recorded. All-cause in-hospital mortality was the main outcome, whereas COVID-19 severity, hospitalization duration and the levels of supplemental oxygen were the secondary outcomes.Results: One hundred forty-eight patients were included, out of which 54.1% were women. The average age was 59.84 ± 19.06 years and 47.3% were elderly, the majority having cardiovascular and metabolic comorbidities. In the elderly group, the most frequent neurological symptoms/manifestations responsible for hospitalization were stroke symptoms followed by confusion, whereas in the non-elderly, headache prevailed. The final neurological diagnosis significantly varied between the two groups, with acute cerebrovascular events and acute confusional state in dementia most commonly encountered in the elderly (65.71 and 14.28%, respectively) and secondary headache attributed to SARS-CoV-2 infection often experienced by the non-elderly (38.46%). The elderly had statistically significant higher median values of white blood cell (8,060 vs. 6,090/μL) and neutrophil count (6,060 vs. 4,125/μL), C-reactive protein (29.2 vs. 5.72 mg/L), ferritin (482 vs. 187 mg/dL), fibrinogen (477 vs. 374 mg/dL), D-dimer (1.16 vs. 0.42), prothrombin time (151.15 vs. 13.8/s), aspartate transaminase (26.8 vs. 20.8 U/l), creatinine (0.96 vs. 0.77 mg/dL), and blood urea nitrogen level (51.1 vs. 27.65 mg/dL), as well as lower median value of hemoglobin (13.05 vs. 13.9 g/dL) and lymphocyte count (1,245 vs. 1,670/μL). Moreover, advanced age was significantly associated with more extensive lung involvement (25 vs. 10%) and higher fatality rate (40 vs. 9%). Overall, the mortality rate was 23.6%. Age as well as neutrophil count, C-reactive protein, fibrinogen, and activated partial thromboplastin time levels were independently associated with mortality.Conclusions: Older age, higher neutrophil count, C-reactive protein, fibrinogen, and activated partial thromboplastin time levels are independent predictors of mortality in COVID-19 patients with new neurological manifestations/conditions at admission.

Neurodegenerative diseases such as Parkinson’s disease (PD)have increasing incidence, due to lifespan expansion. The association between PD and Myasthenia Gravis (MG) is uncommon, and so far, since 1987, 26 cases have been reported. We report here a series of three new cases, two men and one woman with this peculiar combination of conditions, identified in the Neurology Department of Colentina Clinical Hospital. In this article, the pathogenesis of MG in patients with PD is discussed, along with a literature review regarding the co-occurrence of these two neurological diseases.

The novel coronavirus has generated the Coronavirus Disease 2019 (COVID-19) pandemic, which has become the new challenge for the healthcare systems, since there is no etiological treatment and the infectiousness of SARS-CoV2 is exceeding the expectations. Therefore, various treatments have been tried in an attempt to stop the spread of the virus and t o enhance the early recovery of the patients. Hydroxychloroquine, an antimalarial drug used for decades, has been one of the first drugs tried to reduce the infectivity of the virus. First data were promising, but afterwards, adverse events and long-term evolution of patients outweighed the potential benefits, and its utility was questioned. In this article we are reviewing literature regarding the use of Hydroxychloroquine during the COVID-19 pandemic and we present the experience of its use in the

Cytokine storm seems to be one of the main culprits for developing a severe form of COVID-19, IL-6 being one of its basic components. Therefore, currently, tocilizumab is widely studied as a powerful treatment in patients with severe forms of COVID-19. Our aim was to determine whether it could potentiate a favourable outcome in such patients. We conducted a retrospective observational study including all consecutive admitted patients with confirmed SARS-CoV-2 infection that received treatment with tocilizumab in the period between 01.05-23.08.2020 in "Matei Balș" National Institute for Infectious Diseases and Neurology Department of the Colentina Clinical Hospital in Bucharest, Romania. 22 patients were enrolled with a severe form of COVID-19, predominantly women, with an average age of of 61.72 ± 14.5 years. The fatality rate was 31.81%. It was observed that following tocilizumab administration, patients presented improvement in the majority of the studied parameters, statistically significant in the case of fibrinogen, C reactive protein and blood oxygen level (p < 0.05). Tocilizumab might be regarded as a valuable drug in the management of severe SARS-CoV-2 infection. Rezumat Furtuna de citokine pare a fi una dintre principalele cauze pentru dezvoltarea unei forme severe de COVID-19, IL-6 fiind una dintre componentele sale de bază. Prin urmare, în prezent, tocilizumab este studiat pe scară largă ca un tratament la pacienții cu forme severe de COVID-19. Scopul studiului a fost de a determina dacă ar putea potența un rezultat favorabil la astfel de pacienți. S-a realizat un studiu observațional retrospectiv care a inclus toți pacienții internați cu infecție confirmată de SARS-CoV-2 care au primit tratament cu tocilizumab în perioada 01.05-23.08.2020 în cadrul Institutului Național pentru Boli Infecțioase "Matei Balș" și al Departamentului de Neurologie al Spitalului Clinic Colentina din București, România. 22 de pacienți au fost înrolați cu o formă severă de COVID-19, predominant femei, cu o vârstă medie de 61,72 ± 14,5 ani. Rata mortalității a fost de 31,81%. S-a observat că, după administrarea tocilizumab, pacienții au prezentat îmbunătățiri în majoritatea parametrilor studiați, semnificativ statistic în cazul fibrinogenului, al concentrației proteinei C reactive și a l nivelului de oxigen din sânge (p < 0,05). Tocilizumab ar putea fi considerat un medicament valoros în gestionarea infecției severe cu SARS-CoV-2.