Are multiple sclerosis patients and their caregivers more anxious and more committed to following the basic preventive measures during the COVID-19 pandemic?

Talaat, Farouk; Ramadan, Ismail; Aly, Sarah; Hamdy, Eman

doi:10.1016/j.msard.2020.102580

Cited by 21 publications

(51 citation statements)

References 29 publications

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“…Demographic variables that predicted this negative impact were younger age, progressive types of MS and the presence of psychological symptoms. This is consistent with previous research [ 9 , 10 ] that found those of a younger age to be more vulnerable to the negative effects of COVID-19 in the form of increased anxiety at this time. However, the present study also found that location, gender, employment status, time since diagnosis and mood disorder medication use were not significant predictors of negative impact in the model which provides some evidence to the contrary that gender, in this case, has no relationship with the self-reported impact of COVID-19 [ 5 , 8 ].…”

Section: Discussionsupporting

confidence: 93%

“…Older MS patients may be more vulnerable to the effects of social isolation as a result of the pandemic [ 5 ]. However, research has also shown that younger people with MS are more vulnerable to anxiety at this time [ 9 , 10 ]. Similarly, women have been reported to be more susceptible to anxiety than men at this time [ 8 ], yet opposite results have also been found in other research, suggesting men are experiencing higher levels of anxiety during the COVID-19 pandemic [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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The COVID-19 Pandemic Experience in Multiple Sclerosis: The Good, the Bad and the Neutral

Morris-Bankole

2021

Neurol Ther

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Introduction While the current COVID-19 pandemic has affected the lives of many, there is a paucity of information on the impact on people with multiple sclerosis (MS). This study sought to gain insight into the impact of the current situation on people with MS and the factors that influence this. Methods 324 MS patients participated in this online cross-sectional survey during the COVID-19 lockdown period. A mixed methods design was used, with quantitative information collected on MS-related factors as well as COVID-19 impact and an open-ended, qualitative response looking for reasons behind the self-reported COVID-19 impact. Results We found that 48% of the participants reported that COVID-19 had a neutral impact on their lives and 16% reported a positive impact. However, 36% reported a negative impact, and had greater levels of MS- and non-MS-related worries, and higher levels of bother related to psychological and cognitive symptoms and fatigue than the groups reporting a neutral or positive impact. Significant predictors of this adversely affected group were age, type of MS and presence of psychological symptoms. Antidepressant medication use, time since diagnosis, gender, location, living arrangements or employment status did not predict impact. Open-ended responses explaining personal COVID-19 impact indicate that coping strategies may contribute to these findings. In particular, active, problem-focused approaches were reported by the majority of people who reported a positive impact, as well as a third of those who reported a neutral impact. Conclusion These findings suggest that younger people, those with progressive types of MS, and those with psychological symptoms are particularly vulnerable to the negative effects of a COVID-19 pandemic induced lockdown. Coping strategies provide further insight into these findings with those reporting active problem-focused approaches seemingly faring better than those who do not state any coping strategies. These results also have implications for understanding other like neurological conditions that share many similarities with MS and how best to direct support.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The COVID-19 Pandemic Experience in Multiple Sclerosis: The Good, the Bad and the Neutral

Morris-Bankole

2021

Neurol Ther

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“…Considering that only about 20% of seropositive MS patients appear to have symptomatic COVID-19 and that only 5/126 (3.9%) patients were asymptomatic in our cohort, the true prevalence of SARS-CoV-2 infection in the Austrian MS population can be estimated at 4.1% and, thus, lies well within the range of the general population [16]. This is in line with previous studies applying various definitions of SARS-CoV-2 infection/COVID-19 and pharmacoepidemiological techniques adding to the mounting evidence that pwMS are neither more nor less likely to contract SARS-CoV-2 [17][18][19]. Thus, it can be inferred that the AUT-MuSC-19 registry is likely to include most of pwMS with a symptomatic SARS-CoV-2 infections in Austria and is likely representative of a central European, primarily Caucasian MS population.…”

Section: Plos Onesupporting

confidence: 90%

COVID-19 severity and mortality in multiple sclerosis are not associated with immunotherapy: Insights from a nation-wide Austrian registry

et al. 2021

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Background The COVID-19 pandemic challenges neurologists in counselling patients with multiple sclerosis (pwMS) regarding their risk by SARS-CoV-2 and in guiding disease-modifying treatment (DMT). Objective To characterize the prevalence and outcome of COVID-19 in pwMS specifically associated with different DMT in a nationwide population-based study. Methods We included patients aged ≥18 years with a confirmed diagnosis of MS and a diagnosis of COVID-19 established between January 1, 2020 and December 31, 2020. We classified COVID-19 course as either mild, severe or fatal. Impact of DMT and specifically immunosuppressants (alemtuzumab, cladribine, fingolimod, ocrelizumab or rituximab) on COVID-19 outcome was determined by multivariable models, adjusted for a-priori-risk. Results Of 126 MS patients with COVID-19 (mean age 43.2 years [SD 13.4], 71% female), 86.5% had a mild course, 9.5% a severe course and 3.2% died from COVID-19. A-priori-risk significantly predicted COVID-19 severity (R2 0.814; p<0.001) and mortality (R2 0.664; p<0.001). Adjusting for this a-priori-risk, neither exposure to any DMT nor exposure to specific immunosuppressive DMT were significantly associated with COVID-19 severity (odds ratio [OR] 1.6; p = 0.667 and OR 1.9; p = 0.426) or mortality (OR 0.5; p = 0.711 and 2.1; 0.233) when compared to no DMT. Conclusions In a population-based MS cohort, COVID-19 outcome was not associated with exposure to DMT and immunosuppressive DMT when accounting for other already known risk factors. This provides reassuring evidence that COVID-19 risk can be individually anticipated in MS and–except for a very small proportion of high-risk patients–treatment decisions should be primarily focused on treating MS rather than the pandemic.

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“…Our patients had no psychiatric comorbidity, but they still showed anxiety and concern about the pandemic and future expectations. In a recent study, patients with MS were more anxious, stressed, and depressed during the COVID-19 pandemic than their caregivers and people without MS [15]. Given that our patients were not assessed for psychiatric symptoms with the formal psychometric test, adjustments for level of anxiety and depression were not performed.…”

Section: Discussionmentioning

confidence: 99%

Effect of COVID-19 Lockdown on Patients with Multiple Sclerosis: an Italian Survey

Altieri¹,

Fratino²,

Pauri³

et al. 2021

J Neurol Res Rev Rep

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Background: Italy was one of the first affected countries by coronavirus disease 2019 (COVID-19) pandemic. Public health measures like quarantine or national lockdown were adopted, with negative psychological and clinical effects on patients with chronic diseases. To investigate the impact of lockdown on patients with multiple sclerosis (MS), we developed a 36 items self-report questionnaire. Methods: Questionnaires were emailed to 120 patients with MS and 100 with chronic migraine (CM) as a control group, matched for age, sex, and education. The questionnaire was divided into five domains, evaluating concerns about 1) MS and therapy during COVID-19 pandemic, 2) personal and family caregiving, 3) working activities, 4) general and disease-related emotions during the lockdown, 5) future expectations concerning health status, social life, and working activity. Results: patients with MS had higher scores than those with CM in domains 4 and 5, investigating respectively general and disease-related emotions and future expectations (p= 0.05 and 0.02 respectively). About half of the patients with MS expressed some concern about the need to continue their therapy during the pandemic compared to people with CM (p= 0.0002). Conclusions: Covid-19 pandemic had a more negative impact on psychological status of patients with MS compared with those with CM

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Are multiple sclerosis patients and their caregivers more anxious and more committed to following the basic preventive measures during the COVID-19 pandemic?

Cited by 21 publications

References 29 publications

The COVID-19 Pandemic Experience in Multiple Sclerosis: The Good, the Bad and the Neutral

The COVID-19 Pandemic Experience in Multiple Sclerosis: The Good, the Bad and the Neutral

COVID-19 severity and mortality in multiple sclerosis are not associated with immunotherapy: Insights from a nation-wide Austrian registry

Effect of COVID-19 Lockdown on Patients with Multiple Sclerosis: an Italian Survey

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