Chiara Gallo (Italy)
Author Of 1 Presentation
AMYOTROPHIC LATERAL SCLEROSIS PROGRESSION IN THE YEAR OF THE COVID-19 PANDEMIC
- Fabiola De Marchi (Italy)
Abstract
Background and Aims:
During the COVID-19 pandemic and the related lockdowns, the outpatient follow-up visits for patients with chronic neurological diseases have been suspended. In this context, the management of people affected by Amyotrophic Lateral Sclerosis (ALS) has become highly complicated, leaving patients without the standard multidisciplinary follow-up. We aimed to analyze the impact of the COVID-19 lockdown (CL) on ALS disease progression with this study.
Methods:
We compared the clinical data and progression in the first year of disease for a group of patients who received ALS diagnosis during 2020 (2020G, N=34), comparing it with a group of ALS patients diagnosed in 2018 (2018G, N=31). Both groups received a comparable multidisciplinary model of care in our Tertiary Expert ALS Centre in Novara.
Results:
The monthly rate of ALSFRS-R decline during CL was significantly increased in 2020G compared to 2018G (1.52 ± 2.69 vs. 0.76 ± 0.56; p-value: 0.005). In 2020G 47% required Non-Invasive Ventilation (vs. 32% of 2018G) and 32% of patients died (median months from onset to death: 18) vs. 19% of patients in 2018G (median months from diagnosis to death: 35). All results were independently by gender, age, site of onset, and diagnostic delay. Concomitantly, in 2020G, we observed higher level of depression and anxiety (HADS scale).
Conclusions:
Several factors can be implicated in making ALS more severe, with a faster progression. Significant predictors include a reduced medical evaluations and therapeutic changes, social isolation, an increase of anxiety and depression, and rehabilitation therapy suspension.