Treatments that have been proven to positively change the natural course of Multiple sclerosis (MS) and are widely used in the clinical practice are defined as immunosuppressant or immunomodulatory treatments. Oral, subcutaneous or infusion therapies is based on selective modulation or suppression of certain cells, cell subtypes or interleukins of the immune system. İt's accepted that they increase susceptibility to infections at certain rates. The Covid-19 outbreak, which has been declared a global pandemic, has affected large populations in many countries since January 2020. It is a matter of curiosity about how the patients with MS and those under immunomodulatory treatment, will be affected in this pandemic.
We aim to detect the patients with COVID-19 diagnosis among the patients who are followed up with MS diagnosis, whether under immunomodulatory treatment or not and to evaluate how the disease process develops, how the diagnosis of MS and the preventive treatment used affect the disease process.
The patients who are followed up with the diagnosis of demyelinating disease/MS in our Multiple Sclerosis and Demyelinating Disorders outpatient clinic of the Department of Neurology of the Istanbul Bagcilar Training and Research Hospital were included in this study. Patients were contacted via phone or e-mail or were evaluated in the outpatient and inpatient clinics. A questionnaire was conducted about contact with a person who had a positive test result for COVID-19, symptoms of COVID-19, application to a health care facility, possible/definitive diagnosis of COVID-19, and treatment. Thus, patients diagnosed with COVID-19 were identified, and their clinical features and their treatment were summarized.
We are informed that 9 of our patients were diagnosed with COVID-19. While 6 patients were under preventive treatment, 2 patients were followed without treatment and one patient was diagnosed with MS and COVID-19 simultaneously. All of the patients developed mild symptoms associated with COVID-19 and were treated under quarantine under home conditions. Clinical findings of seven patients were found to be compatible with general viral infection findings such as fever, headache, muscle and joint pain. In addition, chest pain and cough complaints compatible with pneumonia were observed in 2 patients. Covid-19 was confirmed by PCR, and preventive treatment of patients was suspended. Covid-19 treatment was started in accordance with the protocol used in our country. No complication related to COVID-19 infection was observed in any patient. After the control tests, the preventive treatment of the patients was resumed. It was determined that most of the patients had other patients in the family.
Based on the information obtained, the measures that can be taken to ensure the continuity of follow-up and treatment of the patients under pandemic conditions are discussed.