Воздействие объема мозга на коронавирусную болезнь 2019 года и последующее когнитивное снижение у пациентов с множественным склерозом.
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Devogelaere Jens, Van Remoortel Ann, Van Laethem Delphine, Faille Laetitia Della, D'hooghe Marie B, Van Schependom Jeroen, Stastna Dominika, Uher Tomas, Nagels Guy, D'Haeseleer Miguel
Аннотация
Оригинал публикации
Impact of brain volume on coronavirus disease of 2019 severity and subsequent cognitive decline in patients with multiple sclerosis.
BACKGROUND: Clinical disability is among the risk factors of a more severe coronavirus disease of 2019 (COVID-19) course in patients with multiple sclerosis (PwMS), but might provide an insensitive reflection of actual tissue pathology. Brain volume loss has emerged as a magnetic resonance imaging (MRI) proxy of neurodegeneration in PwMS. Our main objective was to investigate whether brain volume predicts COVID-19 severity in PwMS.
METHODS: Clinical data of PwMS followed at the Belgian National Multiple Sclerosis (MS) Center in Melsbroek are collected in a local database in case of COVID-19 diagnosis. One hundred ninety-eight unique PwMS with a suitable 3D brain MRI available, conducted maximally 24 months before their COVID-19 infection, were included.
RESULTS: An unfavorable outcome due to COVID-19 was noted in fourteen PwMS (hospitalization: 7.1 %, death: 0.5 %). Neither global nor regional normalized brain volumes predicted COVID-19 severity. Similar results were obtained in patients fulfilling the criteria for benign MS. Being unprotected by vaccination was the only variable significantly associated with a poor COVID-19 outcome (OR 3.7; CI 1.2-10.2). We observed a significant worsening of Symbol Digit Modality Test performance in PwMS with the lowest (Q4) whole brain volume, as compared to those with the highest (Q1) (2.2 ± 8.5 versus -1.2 ± 9.1; P = 0.037).
CONCLUSION: Brain volume does not predict COVID-19 outcome in PwMS, including those with benign MS. Unvaccinated individuals remain susceptible to developing a more severe infection. PwMS with the most profound pre-existing brain atrophy may be at risk for cognitive deterioration after COVID-19.