COVID-19 and Multiple Sclerosis: Predisposition and Precautions in Treatment

Sadeghmousavi, Shaghayegh; Rezaei, Nima

doi:10.1007/s42399-020-00504-9

Cited by 39 publications

(40 citation statements)

References 68 publications

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“…Multiple sclerosis (MS) is a subacute immune-mediated and demyelinating disease of the CNS. The patients' neurological manifestations often exacerbate and relapse due to infection or stress (Sadeghmousavi and Rezaei, 2020 ). The mainstay therapy is immunosuppressants.…”

Section: Neurological Complications Of Covid-19mentioning

confidence: 99%

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Severe Acute Respiratory Syndrome Coronavirus 2-Induced Neurological Complications

2020

Front. Cell Dev. Biol.

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Our review aims to highlight the neurological complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the available treatments according to the existing literature, discussing the underlying mechanisms. Since the end of 2019, SARS-CoV-2 has induced a worldwide pandemic that has threatened numerous lives. Fever, dry cough, and respiratory symptoms are typical manifestations of COVID-19. Recently, several neurological complications of the central and peripheral nervous systems following SARS-CoV-2 infection have gained clinicians' attention. Encephalopathy, stroke, encephalitis/meningitis, Guillain–Barré syndrome, and multiple sclerosis are considered probable neurological signs of COVID-19. The virus may invade the nervous system directly or induce a massive immune inflammatory response via a “cytokine storm.” Specific antiviral drugs are still under study. To date, immunomodulatory therapies and supportive treatment are the predominant strategies. In order to improve the management of COVID-19 patients, it is crucial to monitor the onset of new neurological complications and to explore drugs/vaccines targeted against SARS-CoV-2 infection.

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Section: Neurological Complications Of Covid-19mentioning

confidence: 99%

“…The mainstay therapy is immunosuppressants. In such cases, patients may suffer from severe lymphopenia with poor prognosis if they are involved in COVID-19 simultaneously (Dersch et al, 2020 ; Sadeghmousavi and Rezaei, 2020 ). Additionally, they may develop emerging MS due to post-inflammatory immune response.…”

Section: Neurological Complications Of Covid-19mentioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus 2-Induced Neurological Complications

2020

Front. Cell Dev. Biol.

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“…However a clear causative correlation between SARS-CoV-2 and the new onset or exacerbation of demyelinating diseases is yet to be determined [72]. It has been speculated that SARS-CoV-2 may activate lymphocytes and induce an inflammatory response leading to exacerbation or new onset of demyelinating disorders [73,74].…”

Section: Discussionmentioning

confidence: 99%

Neuroimaging Features of COVID-19: Retrospective Northern Italy Multicenter Study and a Scoping Review of the Prevalence of COVID-19 Associated Acute Cerebrovascular Diseases

Giorgianni

d’Amore

Vinacci

et al. 2021

Preprint

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Background The primary aim of this study was to provide additional data of neuroimaging features of coronavirus disease 2019 (COVID-19) in a large-scale population admitted in several northern Italy institutions. The secondary aim was to analyze acute cerebrovascular disease (CVD) prevalence in COVID-19. Methods A database of confirmed COVID-19 hospitalized patients who developed acute neurological symptoms and underwent any neuroimaging was retrospectively gathered from twelve institutions based in Lombardy from February 21st to July 10th. To assess the prevalence of CVD we conducted a scoping review following the PRISMA extension guidelines for scoping reviews. We searched PubMed/Medline, SCOPUS and EMBASE databases for peer-reviewed in-press or published studies from December to January 2021 reporting CVD in COVID-19 patients. Results Out of 90 COVID-19 patients who were referred to neuroimaging, 78 (87%) showed CVD, in particular 65 had acute ischemic strokes (AIS), 8 had intracerebral hemorrhages, 2 subarachnoid hemorrhages (SAH) and 3 showed clinical and imaging findings in keeping with posterior reversible encephalopathy syndrome (PRES); 6 patients (7%) showed clinical and imaging findings highly suggestive of encephalitis; 3 patients (3%) showed demyelinating diseases: 1 case of MS progression, 1 case of newly diagnosed MS and 1 case of acute disseminated encephalomyelitis (ADEM); 2 cases (2%) acuity of chronic subdural hematoma (cSDH); 1 patient (1%) with Guillain Barré syndrome. In addiction two patients with CVD developed cauda polyradiculitis and tetraparesis. In our scoping review out of 3275 studies, 24 satisfied the inclusion criteria: in a pooled total population of 136198 patients, the pooled prevalence of CVD was 0.9%. In particular 0.8% of AIS and 0.1% of ICH and 0.003% of PRES. Conclusions Our study shows a high prevalence of CVD among patients who developed acute neurological symptoms, which is in line with papers reporting data comparable to ours. The heterogeneity of clinical reports, however, constitutes a limitation when comparing our findings with those of the clinical papers. Nonetheless, CVD could be a frightening association with COVID-19, particularly in critically ill patients. Healthcare policymakers and clinicians should be prepared to a likely increase in workload and to rearrange the strategy of healthcare delivery.

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“…Use of immunosuppressive therapies in MS patients might cause extra risks in the course of COVID-19. However, published case reports noted that taking DMTs was not related with a significantly enhanced risk of hospitalization or fatal outcome [ 121 ]. Parrotta et al demonstrated that the most common COVID-19 symptoms among MS patients taking DMTs were cough and fever; however, 21% of patients had neurologic symptoms return, which occurred coinciding with the SARS-CoV-2 infection.…”

Section: Does Infection Of Sars-cov-2 May Be An Actual Neurodegenementioning

confidence: 99%

The Impact of SARS-CoV-2 Infection on the Development of Neurodegeneration in Multiple Sclerosis

Dziedzic

Saluk‐Bijak

Miller

et al. 2021

IJMS

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The novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a global challenge. Currently, there is some information on the consequences of COVID-19 infection in multiple sclerosis (MS) patients, as it is a newly discovered coronavirus, but its far-reaching effects on participation in neurodegenerative diseases seem to be significant. Recent cases reports showed that SARS-CoV-2 may be responsible for initiating the demyelination process in people who previously had no symptoms associated with any nervous system disorders. It is presently known that infection of SARS-CoV-2 evokes cytokine storm syndrome, which may be one of the factors leading to the acute cerebrovascular disease. One of the substantial problems is the coexistence of cerebrovascular disease and MS in an individual’s life span. Epidemiological studies showed an enhanced risk of death rate from vascular disabilities in MS patients of approximately 30%. It has been demonstrated that patients with severe SARS-CoV-2 infection usually show increased levels of D-dimer, fibrinogen, C-reactive protein (CRP), and overactivation of blood platelets, which are essential elements of prothrombotic events. In this review, the latest knowledge gathered during an ongoing pandemic of SARS-CoV-2 infection on the neurodegeneration processes in MS is discussed.

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COVID-19 and Multiple Sclerosis: Predisposition and Precautions in Treatment

Cited by 39 publications

References 68 publications

Severe Acute Respiratory Syndrome Coronavirus 2-Induced Neurological Complications

Severe Acute Respiratory Syndrome Coronavirus 2-Induced Neurological Complications

Neuroimaging Features of COVID-19: Retrospective Northern Italy Multicenter Study and a Scoping Review of the Prevalence of COVID-19 Associated Acute Cerebrovascular Diseases

The Impact of SARS-CoV-2 Infection on the Development of Neurodegeneration in Multiple Sclerosis

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