COVID-19'un Hastalık Modifiye Edici Tedavi Alan Multipl Sklerozlu Bireylerdeki Hastalık Aktivitesi, Progresyonu ve Bilişsel İşlev Bozukluğu Üzerine Etkisi
DOI:
https://doi.org/10.5281/zenodo.17987476Anahtar Kelimeler:
Anahtar Kelimeler: COVID-19, Multipl Skleroz, Hastalık modifiye edici tedavilerÖzet
COVID-19 (Koronavirüs Hastalığı-19) pandemisinin başlangıcından bu yana, Multipl Sklerozlu (MS) hastaların bu viral enfeksiyondan nasıl etkilenecekleri merak konusu olmuştur. COVID-19 enfeksiyonu ile ilişkili santral sinir sistemine ait demyelinizan olayların rapor edilmesi, hastalık modifiye edici tedavilerin (Disease-modifying therapies, DMT) bağışık yanıt üzerindeki etkilerinin COVID-19’un seyrini değiştirebileceğinin öne sürülmesi, klinik sonuçlar hakkında bilgi toplama ihtiyacını doğurmuştur. COVID-19 enfeksiyonu ile ilişkili olarak ortaya çıkan demiyelinizan olaylar ile enfeksiyonla ilişkili olmayan olaylar arasında atak şiddeti ve akut tedavilere yanıtla igili farklılıklar olup olmadığı konusundaki araştırmalar devam etmektedir. Bu çalışma COVID-19 enfeksiyonuna yakalanan, DMT almakta olan 30 MS’li hastada, COVID-19 enfeksiyonunun MS’in seyrine etkisini araştırmak amacıyla yapılmıştır. Ocak 2020-Ocak 2024 tarihleri arasında MS tanısı ile takipli olan 30 hasta, hastalığın progresyonu, nüksler, manyetik rezonans görüntüleme (MRG) bulgularındaki değişiklikler (beyin lezyonları) ve bilişsel (kognitif) etkilenme açısından 36 ay boyunca değerlendirildi. 30 hastanın 20'si kadın 10’u erkek hasta idi. Yaş aralığı 25-70 arasında değişmekteydi. Hastalık tipleri olarak 5 olgu Sekonder Progresif Multipl Skleroz (SPMS), 25 olgu Relapsing-Remitting Multipl Skleroz (RRMS) idi. DMT’ler 20 olguda Dimetil Fumarat, 10 olguda Fingolimod idi. SPMS’u olan hastalardan 2’sinde COVID-19 enfeksiyonu sonrasında şiddetli nüks (atak) görüldü. Bu hastalar fingolimod kullanmaktaydı. Tüm grup içinde 28 hastada; nüks, progresyon, MRG bulgularında değişiklik ve bilişsel işlevlerde bozulma görülmedi. Bu çalışmada COVID-19'un MS hastalığı üzerine olumsuz etkilerinin olduğunu gösteren bulgular saptanmadı.
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