Title : The Clinical And Psychological Effect of COVID19 Pandemic on Neuromyelitis Optica Spectrum Disorder Patients.
Abstract:
Coronavirus 2019 was a new coronavirus created a pandemic with high mortality. People with underlying disease and immune system suppression are potentially prone to infection. The nature of NMOSD disease as well as its treatment by immunosuppressants predisposes patients to infection. The coronavirus epidemic in a few months lead to significant changes in people's lifestyles and attitudes. Public health measures such as quarantine to prevent the spread of the disease have had a negative psychological impact. People with chronic illnesses, including Neuromyelitis Optica (NMOSD) are more prone to neuropsychiatric disorders, which can lead to fear of continuing treatment.
The aim of study was to evaluate the effect of COVID19 pandemic on the clinical course of NMOSD and the characteristics of COVID19 infection in NMOSD patients after a year. Also to investigate the level of anxiety and its changes in NMOSD patients during COVID19 pandemic. The another issue was determining patients' adherence to precautionary measures and health protocols.
Study included 120 patients (41 seropositive , 96 female). Mean age was 36.37±9.69 and mean duration of disease was 8.49±5.35 years . We considered relapses during the year of epidemic and the year before and the presentation of COVID19 infection in the patients of NMOSD Clinic of Isfahan Kashani hospital. Patients were asked also about changes in maintenance therapy. We asked patients if they were anxious or afraid of the pandemic subjectively. To investigate the objective level of anxiety, we benefited Hospital Anxiety and Depression Scale (HADS-A) questionnaire. We asked them about respecting general health cautions to prevent infection too.
Results showed that in spite of suppression of the immune system, neither incidence nor the number of the serious complications of COVID19 infection was high. Therefore, regarding the disabling nature of NMOSD as well as prolonged epidemic period, it may be reasonable to continue the routine treatment of these patients along with training patients to stick to health protection instructions. Along with the pandemic prolongation, the level of anxiety decreased gradually while the level of alertness was almost high. The COVID19 vaccination had a dramatic effect on decreasing fear and anxiety and improving mental health
What will audience learn from your presentation?
- In spite of immunosuppressive therapy in NMOSD patients, the cases infected by COVID-19 didn’t experience severe complications or atypical presentation.
- Immunosuppressant therapy can be continued routinely in NMOSD patients during COVID19 epidemic , but any expansion of dosing interval should be according to clinical and paraclinic findings of patients under recommendation of neurologist.
- Patients with NMOSD are at a great risk of psychiatric effects of COVID-19 epidemic such as anxiety and depression.
- The anxiety level decreased gradually during epidemic period specially after vaccination program but they stick health protection measures more.
- The COVID19 vaccination have positive effect on improving mental health.
