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2020 ; 35
(6
): 357-362
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Tratamiento inmunosupresor en pulsos en esclerosis múltiple durante el
desescalado de la epidemia por SARS-CoV-2 Algoritmo de seguridad
#MMPMID32591152
Valero-López G
; Carreón-Guarnizo E
; Hernández-Clares R
; Iniesta-Martínez F
; Jiménez-Veiga J
; Moreno-Docon A
; Iborra-Bendicho MA
; Aznar-Robles E
; Hellín-Gil MF
; Morales-Ortiz A
; Meca-Lallana JE
Neurologia (Engl Ed)
2020[Jul]; 35
(6
): 357-362
PMID32591152
show ga
INTRODUCTION: The COVID-19 pandemic is changing approaches to diagnosis,
treatment, and care provision in multiple sclerosis (MS). During both the initial
and peak phases of the epidemic, the administration of disease-modifying drugs,
typically immunosuppressants administered in pulses, was suspended due to the
uncertainty about their impact on SARS-CoV-2 infection, mainly in contagious
asymptomatic/presymptomatic patients. The purpose of this study is to present a
safety algorithm enabling patients to resume pulse immunosuppressive therapy
(PIT) during the easing of lockdown measures. METHODS: We developed a safety
algorithm based on our clinical experience with MS and the available published
evidence; the algorithm assists in the detection of contagious
asymptomatic/presymptomatic cases and of patients with mild symptoms of
SARS-CoV-2 infection with a view to withdrawing PIT in these patients and
preventing new infections at day hospitals. RESULTS: We developed a
clinical/microbiological screening algorithm consisting of a symptom checklist,
applied during a teleconsultation 48hours before the scheduled session of PIT,
and PCR testing for SARS-CoV-2 in nasopharyngeal exudate 24hours before the
procedure. CONCLUSION: The application of our safety algorithm presents a
favourable risk-benefit ratio despite the fact that the actual proportion of
asymptomatic and presymptomatic individuals is unknown. Systematic PCR testing,
which provides the highest sensitivity for detecting presymptomatic cases,
combined with early detection of symptoms of SARS-CoV-2 infection may reduce
infections and improve detection of high-risk patients before they receive PIT.
|*Algorithms
[MESH]
|Ambulatory Care
[MESH]
|Asymptomatic Diseases
[MESH]
|Betacoronavirus/*isolation & purification
[MESH]
|COVID-19
[MESH]
|COVID-19 Testing
[MESH]
|Checklist
[MESH]
|Clinical Laboratory Techniques
[MESH]
|Contraindications, Drug
[MESH]
|Coronavirus Infections/diagnosis/*prevention & control
[MESH]
|Disease Susceptibility
[MESH]
|Humans
[MESH]
|Immunocompromised Host
[MESH]
|Immunosuppressive Agents/*administration & dosage/adverse effects/therapeutic use
[MESH]
|Mass Screening/methods
[MESH]
|Multiple Sclerosis/*drug therapy
[MESH]
|Nasopharynx/virology
[MESH]
|Pandemics/*prevention & control
[MESH]
|Pneumonia, Viral/diagnosis/*prevention & control
[MESH]