COVID-19 Late Breaking Abstracts

LB1281 - Experience of a northeast Brazilian demyelinating disorders center in remote screening of COVID-19 during the sars-cov-2 pandemic. (ID 2181)

Speakers
  • I. Santiago
Authors
  • I. Santiago
  • M. Pitombeira
  • L. Mendes
  • I. Pereira Nobrega
  • I. Dantas
  • K. De Morais
  • P. D´almeida
  • C. Da Silva
  • P. Lisboa
  • M. De Melo
  • M. Gonçalves
  • G. Martins
  • J. Costa D'Almeida
Presentation Number
LB1281
Presentation Topic
COVID-19

Abstract

Background

The coronavirus disease 2019 (COVID-19) crisis and the need to evaluate patients from distance due to social isolation has brought telemedicine into a new light. In response to the pandemic, our center for multiple sclerosis (MS) and other demyelinating disorders rapidly switched from in-person to remote telehealth care, initially to monitor disease activity and provide a COVID-19 remote screening.

Objectives

To apply remote screening for COVID-19 cases and asses the outcome for those that matched the clinical criteria, comparing the findings with the ongoing international data.

Methods

From April 1 to August 1, patients with MS and other demyelinating disorders in a reference center at Fortaleza-Brazil were submitted by phone call to clinical COVID-19 criteria. The criteria were: 1) Classical triad off fever, dry cough, and myalgia/fatigue/asthenia, 2) Sudden hyposmia or hypogeusia in the absence of nasal obstruction, 3) 2 of 4: fever, dry cough, myalgia/fatigue/asthenia, diarrhea/abdominal pain, hyposmia/hypogeusia with nasal obstruction. A follow-up call was made in 4 weeks average to assess the outcome.

Results

From 468 registered patients, 349 were successfully contacted by phone calls. 60 patients were defined as suspects, 53 answered the follow-up call. Of those, 84.9% were female and 67.9% were relapsing-remitting MS patients. The most common disease modifying drug in use was dimethyl fumarate (16.9%) and fingolimod (15.1%), the less being natalizumab (3.8%). 11.1% of them interrupted the current treatment during the crisis. The majority (77.4%) had no comorbidities and the most prevalent symptoms were headache (49%), myalgia (49%), hyposmia (45.2%) fever (43%), cough (43%) and hypogeusia (41%). About 45.2% reached medical care, but 58.5% were submitted to some sort of COVID-19 treatment, what implies in cases of self-medication, the most common being azithromycin (50.9%) and the less, chloroquine (9.4%). 2 patients were admitted to hospital care and there were no deaths. 26.4% were confirmed cases, 13.2% were discarded and 60.4% remained as suspects due to lack of diagnostic tests. 96.2% of the patients were asymptomatic by the follow up call.

Conclusions

We converted most of our patient care to telehealth encounters and were able to effectively submit them to a COVID-19 screening. The experience and the findings suggest that the strategy is feasible and effective. Although we had difficulties to apply laboratory diagnostic tests, our data was compatible with the ongoing literature and suggested that individuals with MS and other demyelinating disorders had similar COVID-19 clinical course as the general population.

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