Welcome to the WCN 2021 Interactive Program

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    Please note that all sessions will run at their scheduled time and be followed by a LIVE Q&A/Discussion at the end

     The viewing of sessions, cannot be accessed from this conference calendar. All sessions are accessible via the Virtual Platform

Displaying One Session

Free Communication
Session Time
09:30 - 11:00
Room
Free Communication C
Chair(s)
  • Alberto Priori (Italy)
Free Communication

MAINTAINING ACUTE STROKE CARE DURING THE COVID-19 PANDEMIC: THE TUSCANY STROKE NETWORK PERFORMANCE IN 2020

Session Type
Free Communication
Date
06.10.2021, Wednesday
Session Time
09:30 - 11:00
Room
Free Communication C
Lecture Time
09:30 - 09:40
Presenter
  • Marzia Baldereschi (Italy)

Abstract

Background and Aims:

The COVID 19 pandemic is impacting on acute ischemic stroke (AIS) care: fewer patients reach the hospital within the therapeutic time-window. We aim at describing and quantifying this impact in terms of number of stroke hospital admissions and treatments across the Tuscany Stroke Network (TSN) in 2020.

Methods:

The TSN was implemented in 2015 and it is structured as three hub-and-spoke systems throughout Tuscany. We retrospectively included all AIS patients admitted and those treated in each of the 22 TSN hospitals during 2020, using the 2019 as a comparator.

Results:

From January 1 through December 31 2020, a total of 1388 treatments were administered to AIS patients, being 1536 during the same period of 2019. Compared with 2019, AIS hospital admissions in 2020 decreased by 11.7% while reperfusion treatments only by 9.5%. In particular, thrombolysis decreased by 10% but endovascular tratments increased by 11.7%. Single month as well as single hospital performances varied a lot.

Conclusions:

During 2020, secondary to stay-at-home orders and possibly patients wanting to avoid healthcare facilities, stroke volumes decreased significantly across Tuscany. In addition, many patients reached hospitals beyond thrombolysis therapeutic window and were transferred to the hub for endovascular treatment. The logistic interventions provided by the TSN counterbalanced the deleterious effects of the COVID 19 outbreak on AIS care. Our data suggest both the need and the benefit of organized stroke systems. Only a well-established hospital network can adjust its organization and logistics to quickly and effectively deal with an unexpected health problem

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Free Communication

COVID-19-ASSOCIATED GUILLAIN-BARRÉ SYNDROME IN THE FIRST WAVE OF COVID-19 PANDEMIC IN LOMBARDIA: INCREASED INCIDENCE OR INCREASED SEROPREVALENCE?

Session Type
Free Communication
Date
06.10.2021, Wednesday
Session Time
09:30 - 11:00
Room
Free Communication C
Lecture Time
09:40 - 09:50
Presenter
  • Filippo G. Martinelli Boneschi (Italy)

Abstract

Background and Aims:

Several studies reported increased incidence of Guillain-Barre’ Syndrome (GBS) after Zika
epidemic, SARS-CoV and MERS, and more recently SARS-CoV-2 infection. We estimate
incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients in
one of the most affected regions by COVID-19 of the world, Lombardia.

Methods:

A multi-center observational study on neurological complications in COVID-19 patients was conducted in 20 Neurology Departments by the Italian society of Hospital Neuroscience (SNO). Adult patients admitted to Neurological units between February-April 2020 with COVID19-GBS were included.

Results:

38 COVID19-GBS patients had mean age of 60.7 years and male frequency of 86.8%. Mean interval between COVID-19 onset and GBS onset was 15.1 days. CSF albuminocytologic dissociation was detected in 71.4% of cases, PCR for SARS-CoV-2 negative in all 15 tested patients, and anti-ganglioside antibodies positive in 43.7%. Based on neurophysiology, 81.8% of patients had a diagnosis of AIDP diagnosis, 12.1% AMSAN and 6% AMAN. 29 patients have been treated with intravenous Immunoglobulin (IVIg), 2 with plasma exchange (PE), 2 with PE followed by IVIg and 5 untreated. The course was favorable in 76.3% of patients, stable in 10.5%, while 13.1% worsened, of which 3 died. The estimated occurrence rate in Lombardia is 0.5 GBS cases per 1000 COVID-19 infections.

Conclusions:

We detected an increased incidence of GBS in COVID-19 patients which can reflect a higher risk of GBS in COVID-19 patients or be secondary to a higher seroprevalence of COVID-19 in this geographic area during the first pandemic wave.

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Free Communication

PRELIMINARY EVIDENCE OF BLUNTED HUMORAL RESPONSE TO SARS-COV-2 (MRNA) VACCINE IN MULTIPLE SCLEROSIS PATIENTS TREATED WITH OCRELIZUMAB.

Session Type
Free Communication
Date
06.10.2021, Wednesday
Session Time
09:30 - 11:00
Room
Free Communication C
Lecture Time
09:50 - 10:00
Presenter
  • Antonio Gallo (Italy)

Abstract

Background and Aims:

Since the worldwide launch of the SARS-CoV-2 vaccine campaign, several concerns apply on the response to vaccines in people with multiple sclerosis (pwMS) particularly those on high efficacy disease modifying therapies (DMTs).

We report preliminary data on humoral response to Covid-19 vaccine assessed on four pwMS treated with ocrelizumab (OCR) and compared to that measured in a sample of healthy subjects (HS) enrolled in a surveillance programme at our Clinic.

Methods:

We collected serum samples -at 0,14,21 days after the first dose and 7 days after the second dose of NT162b2-mRNA-Covid-19 vaccine of: i) 55 health-care workers, and ii) four relapsing MS patients on OCR, that were vaccinated with the same Covid-19 vaccine. All subjects did not have a history of Covid-19 infection. Sera were tested using the LIAISON®SARS-CoV-2 TrimericS-IgG assay (DiaSorin-S.p.A.), for the detection of IgG antibodies to SARS-CoV-2 spike protein. The IgG-titers were expressed in Binding Antibody Units (BAU).

Results:

Seven days after the second dose of NT162b2-mRNA-Covid-19 vaccine, all HS mounted a significant humoral response (geometric mean 2010.4 BAU/mL C.I.95%1512.7-2672), while all the four pwMS showed a very low response (range 4,9-175 BAU/mL).

Conclusions:

As expected and in agreement with previous data, we found a blunted humoral response to NT162b2-mRNA-vaccine in pwMS treated with OCR. Further data are urgently needed in order to confirm and expand these preliminary, yet significant results and to inform if there is any strategy to optimize the response to vaccines such as the count of circulating CD20 cells, time-elapsed since the last anti-CD20 drug administration.

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Free Communication

AMYOTROPHIC LATERAL SCLEROSIS PROGRESSION IN THE YEAR OF THE COVID-19 PANDEMIC

Session Type
Free Communication
Date
06.10.2021, Wednesday
Session Time
09:30 - 11:00
Room
Free Communication C
Lecture Time
10:00 - 10:10
Presenter
  • 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.

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Free Communication

THE IMPACT OF COVID-19 PANDEMIC ON COGNITION OF PEOPLE WITH DEMENTIA

Session Type
Free Communication
Date
06.10.2021, Wednesday
Session Time
09:30 - 11:00
Room
Free Communication C
Lecture Time
10:10 - 10:20
Presenter
  • Giacomo Tondo (Italy)

Abstract

Background and Aims:

To limit the COVID-19 outbreak, the Italian government implemented social restrictions that may have had psychological and cognitive repercussions on people with dementia. We aimed to analyze cognitive decline during the pandemic year in people evaluated in a Memory Clinic in Northern Italy, the epicenter of COVID-19 spread.

Methods:

Single-center retrospective study, including individuals with annual follow-up evaluated in three different years (2020-GROUP, 2019-GROUP, 2018-GROUP). We performed an intergroup comparison of cognitive decline over a one-year follow-up, and an intragroup comparison in the 2020-GROUP to analyze the five-year cognitive decline trajectory, as measured by the MMSE.

Results:

The 2020-GROUP showed a significant loss of MMSE points per year in the considered follow-up period compared with the 2019-GROUP and 2020-GROUP (p=0.021). Demographics, clinical features, and none of the other analyzed variables, including rate of diagnosis, therapy and comorbidities, significantly differed between groups. The five-year cognitive decline trajectory confirmed a significant worsening of cognitive decline between 2019 and 2020 (p < 0.001), while the decrease in MMSE scores was not statistically significant between previous time points.

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Conclusions:

COVID-19 pandemic measures have induced a significant worsening of cognitive decline in people with dementia, needing more careful assistance to minimize the adverse effects of social isolation in case of future lockdowns.

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Free Communication

EVALUATION OF PHANTOSMIA AND PHANTOGEUSIA IN PATIENTS AFTER COVID-19: A PILOT STUDY

Session Type
Free Communication
Date
06.10.2021, Wednesday
Session Time
09:30 - 11:00
Room
Free Communication C
Lecture Time
10:20 - 10:30
Presenter
  • Tommaso Ercoli (Italy)

Abstract

Background and Aims:

Olfactory and taste dysfunction are common symptoms of the acute phase of the COVID-19. To date little is known about the long-term sequelae of SARS-CoV-2 in the olfactory and gustatory systems. The aim of this study is to assess the presence of dysfunctional smell and taste detection in long-covid patients.

Methods:

We enrolled 17 consecutive patients who had suffered from COVID-19 over the last six months. Olfactory and taste function was evaluated with the Sniffin’ Sticks Extended test (SSET) and with the Taste Strips (TS) respectively. The presence of phantosmia, phantogeusia, parosmia and parageusia was investigated with specific questionnaires.

Results:

Phantosmia was observed in 2/17 (11.8%) long-covid patients, while none of our patients reported phantogeusia. Parosmia and parageusia were assessed in 2/17 (11.8%) and 3/17 (17.6%) patients respectively. The SSET revealed hyposmia in patients with parosmia, while all patients showed normogueusia at the TS test.

Conclusions:

The long-term sequelae of COVID-19 are still unknown, and the involvement of the nervous system is debated. Our study showed that patients who recovered from COVID-19 might have persistent dysfunction in smell and taste detection ability. More studies are needed in order to better evaluate the frequency of phantosmia, phantogeusia, parosmia and parageusia in long-covid patients.

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Free Communication

LINKING EUROPE AND SUB-SAHARAN AFRICA IN THE COVID-19 ERA. PARTNERSHIP AND TELENEUROLOGY

Session Type
Free Communication
Date
06.10.2021, Wednesday
Session Time
09:30 - 11:00
Room
Free Communication C
Lecture Time
10:30 - 10:40
Presenter
  • Massimo Leone (Italy)

Abstract

Background and Aims:

Low patients’ retention summarizes difficulties of chronic care programs in sub-Saharan Africa (SSA): about 50% of the patients are lost to follow up few years after initiating treatments hampering epilepsy and stroke management. COVID-19 care disruption can increase epilepsy and stroke mortality particularly among HIV+ patients - as HIV increases epilepsy and stroke risks. Teleneurology can contribute to limit care disruption in SSA.

Methods:

Since 2008 Global Health Telemedicine (GHT) offers advices from European neurologists and education from remote to thousands of African health workers particularly of the Disease Relief through Excellent and Advanced Means (DREAM) health program. In 2019 the Italian Society of Neurology, the C.Besta Neurologic Institute and the Mariani Foundation joined the DREAM-GHT education program in basic neurology in Malawi and Central African Republic (CAR). The impact of the partnership can be measured by comparing 1. the one year-total number of teleconsultations and 2. patients’ retention before (2019) and during COVID (2020).

Results:

In Malawi the DREAM program follows 17280 patients (88% HIV+): the lost-to-follow up before and during COVID-19 were 1,3% and 1,04% respectively. The total number of GHT-teleconsultations with Africa dropped from 3095 in 2019 to 2047 in 2020, -33,9%. On the opposite teleneurology consultations in Malawi and CAR increased from 91 in 2019 to 141 in 2020, +54,9%; 72% were for epilepsy.

Conclusions:

Partnerships supporting teleneurology break COVID-19-provoked-isolation to improve local health providers work; this favours patients’ trust and retention. The combined effect can limit COVID-19 care disruption.

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Free Communication

IMPACT OF COVID-19 ON PARKINSON’S DISEASE: THE EXPERIENCE OF AN ITALIAN CENTRE

Session Type
Free Communication
Date
06.10.2021, Wednesday
Session Time
09:30 - 11:00
Room
Free Communication C
Lecture Time
10:40 - 10:50
Presenter
  • Sandy M. Cartella (Italy)

Abstract

Background and Aims:

Covid-19 had a negative impact on motor and non-motor aspects of movement disorders. The aim of this work is To assess the impact of Covid-19 on Parkinson’s Disease patients, with regard on non-motor symptoms, social aspects and everyday life.


Methods:

Self-administered survey, based on Hamilton Depression and Anxiety Rating Scale, UPDRS, Hospital Anxiety and Depression Scale. Motor evaluation (UPDRS III) before and after lockdown.

Results:

We analysed 33 patients. 50% of them felt more depressed and anxious than before lockdown. Sleep quality decreased for 38% of patients. These features are related between them and with the patients’ level of education. For 5 patients hallucinations got worse, while four experienced worsened binge-eating disorder, one had ICDs and DDS for the first time. 43% of patients felt more fatigued, 58% of them felt more slowness of movements. 37% of patients felt their FOG worsened, 44% felt their posture did and 29% got worse motor fluctuations. UPDRS III worsened in 38% of patients. Only 5 patients had difficulty in finding their doctors, none of them in finding their drugs. 6 patients knew what telemedicine is, and 4 of them used it. 29% of patients said their health and quality of life decreased. For 51% of patients the most important problem was the impossibility to practice physiotherapy. Most people emailed our centre to postpone appointments or to seek medical advice, only 1% asked for Covid-19 related issues and telemedicine consultations.

Conclusions:

Covid-19 had a negative impact on motor and non-motor symptoms of PD, with quality of life repercussions.

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Free Communication

LIVE Q&A

Session Type
Free Communication
Date
06.10.2021, Wednesday
Session Time
09:30 - 11:00
Room
Free Communication C
Lecture Time
10:50 - 11:00