<p>Management Strategies of Patients with Neuromyelitis Optica Spectrum Disorder During the COVID-19 Pandemic Era</p>

Abstract

The ongoing coronavirus (COVID-19) pandemic is a global health emergency of international concern and has affected management plans of many autoimmune disorders. Immunosuppressive and immunomodulatory therapies are pivotal in the management of neuromyelitis optica spectrum disorder (NMOSD), potentially placing patients at an increased risk of contracting infections such as COVID-19. The optimal management strategy of NMOSD during the COVID-19 era remains unclear. Here, however, we examined the evidence of NMOSD disease-modifying therapies (DMTs) use during the present period and highlighted different scenarios including treatment of relapses as well as initiation and maintenance of DMTs in order to optimize care of NMOSD patients in the COVID-19 era.

COVID-19 and vaccination against SARS-CoV-2 in patients with neuromyelitis optica spectrum disorders

“…Similar to our results, predominance of women, which could be explained with the well-known data that NMOSD affects women more frequently than men ( Pandit et al., 2015 ), was also demonstrated in the French ( Louapre et al., 2020 ), Czech ( Stastna et al., 2021 ) and Iranian cohort of NMOSD patients with COVID-19 ( Sahraian et al., 2020 ). Having in mind, chronic neurological disability and maintenance immunosuppressive therapy in NMOSD, these patients are at higher risk of COVID-19 ( Hamdy et al., 2020 ). Moreover, older age, shorter disease duration and higher disability, measured by EDSS, have been demonstrated in the multi-center French NMOSD study, to influence susceptibility to develop severe COVID-19 ( Louapre et al., 2020 ).…”

Vaccination in neuromyelitis optica spectrum disorders: Friend or enemy?

“…Notably, severe COVID-19 infections are more frequent in elder patients (>60 years) with a higher case-fatality rate (CCDC, 2021). Considering the increased risk of death associated with other underlying diseases (cardiopulmonary disease and diabetes mellitus) and the modest benefit of disease-modifying treatment for elderly NMOSD patients, treatment decisions for this group should be individualized (Hamdy et al, 2020).…”

Neuromyelitis optica spectrum disorder: epidemiology, pathogenesis, diagnosis, treatment, and prognosis

“…Do zës nu sta to mos in di vi du a liai pa gal pa cien to li gos sun ku mà, lim fo ci tø skai èiø. Jei lim fo ci tø kie kis su ma þë ja iki 500/mm 3 ar ba, gy dant me tot rek sa tu, pa si reið kia pneumo ni tas, tai ky tà gy dy mà rei kë tø nu trauk ti ir pra dë ti skir ti mo nok lo ni nius an ti kû nus [40].…”

“…Èemerkaitë, I. Kaukënaitë, R. Liutkevièienë 1 pav. NMOSD recidyvø gydymas COVID-19 pandemijos laikotarpiu[40]…”