The impact of Covid19 pandemic on neuromyelitis optica spectrum disorder patients, after one year of epidemic: A report from Isfahan, Iran

Coronavirus 2019 created a pandemic with high mortality. Underlying disease and immune system suppression make prone to infection. The nature of NMOSD disease as well as its treatment by immunosuppressants predisposes patients to infection. The aim of study was to evaluate the effect of Covid19 pandemic on the clinical course of NMOSD and the characteristics of Covid19 infection in patients after a year. We considered relapses during the year of epidemic and the year before and the presentation of Covid19 infection in the NMOSD patients. Patients were asked also about changes in maintenance therapy. Study included 120 patients (96 female). Mean age was 36.37±9.69 and mean disease duration was 8.49±5.35. Overall, 36 relapses reported during the year before epidemic (ARR:0.3) and 29 relapses during Covid19 epidemic (ARR:0.24). The maintenance therapy of NMOSD was rituximab in 96 cases, azathioprine in 22 and methotrexate in 2 ones.35 patients infected by Covid19 (diagnosis by RT-PCR test).6 of them admitted in hospital and two received ICU care. There was one death due to respiratory failure. Five patients experienced gastrointestinal symptoms as the presentation. Their mean age was 36.02±10.11 years and the disease duration was 6.82±4.62. 20 of 35 patients reported close contact with COVID19 cases (among relatives) before infection. Results showed in spite of suppression of the immune system, neither incidence nor the number of the serious complications of COVID19 infection was high. Regarding the disabling nature of NMOSD as well as prolonged epidemic period, it may be reasonable to continue the routine treatment of these patients along with training patients to stick to health protection instructions.  

The impact of Covid19 pandemic on neuromyelitis optica spectrum disorder patients, after one year of epidemic: A report from Isfahan, Iran Keywords:

Covid19 pandemic