The Impact of COVID-19 Pandemic on Neuromyelitis Optica Disorder Patients, After one Year

Abstract

Background: Coronavirus Disease 2019 (COVID-19) recently created a pandemic with high mortality. People with underlying diseases are prone to severe infection. The nature of NMOSD disease and its treatment by immunosuppressants predisposes patients to infection. Objectives: This study aimed to evaluate the effect of the COVID-19 pandemic on the clinical course of NMOSD and the characteristics of COVID-19 infection in NMOSD patients. Materials & Methods: This descriptive study was performed in Isfahan City, Iran, Iran, from March 2020 to March 2021. We considered relapses during the epidemic and the year before and the presentation of COVID-19 infection in the patients of NMOSD Clinic of Isfahan Kashani hospital. Results: The study included 120 patients. Their Mean±SD age was 36.37±9.69 years, and the mean duration of disease was 8.49±5.35 years. Overall, they experienced 36 relapses during the year before the epidemic (ARR:0.3) and 29 during the COVID-19 epidemic (ARR:0.24). The maintenance therapy of NMOSD was rituximab in 96 cases, azathioprine in 22, and methotrexate in 2 ones. 35 patients infected by COVID-19 (based on RT-PCR test). 6 were admitted to the hospital, and two patients received ICU care. There was one death due to respiratory failure. Conclusion: Despite the suppression of the immune system, neither incidence nor the number of severe complications of COVID-19 infection was high. Therefore, regarding the disabling nature of NMOSD and the prolonged epidemic period, it may be reasonable to continue the routine treatment of these patients and train them to stick to health protection instructions.