Immunosuppressive therapy and COVID‐19 infection in patients with NMOSD

Abstract Introduction To evaluate whether treated with immunosuppressants in neuromyelitis optica spectrum disorder (NMOSD) shows an effect on the severity and outcomes of COVID‐19 Omicron variant. Methods This is a substudy of a single‐center clinical trial involving human umbilical cord mesenchyma...

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Main Authors: Un Wai Choi, Xiwen Ai, Hongyan Li, Yong Hao, Xiaoying Yao, Yangtai Guan
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Immunity, Inflammation and Disease
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Online Access:https://doi.org/10.1002/iid3.1128
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author Un Wai Choi
Xiwen Ai
Hongyan Li
Yong Hao
Xiaoying Yao
Yangtai Guan
author_facet Un Wai Choi
Xiwen Ai
Hongyan Li
Yong Hao
Xiaoying Yao
Yangtai Guan
author_sort Un Wai Choi
collection DOAJ
description Abstract Introduction To evaluate whether treated with immunosuppressants in neuromyelitis optica spectrum disorder (NMOSD) shows an effect on the severity and outcomes of COVID‐19 Omicron variant. Methods This is a substudy of a single‐center clinical trial involving human umbilical cord mesenchymal stem cells (hUC‐MSCs) in NMOSD patients. NMOSD patients with hUC‐MSCs treatment, NMOSD patients without hUC‐MSCs treatment, and matched healthy controls (HC) were included. Demographic information, NMOSD‐related clinical features, comorbidities, use of disease‐modifying therapy, COVID‐19 vaccination status, COVID‐19 clinical features, COVID‐19 clinical outcomes, and NMOSD‐related disease activity were obtained through online questionnaires or phone calls. Results The majority of NMOSD patients received long‐term treatment with mycophenolate mofetil (68.8%) or azathioprine (22.9%), and 50% received oral glucocorticoid. During the epidemic, 97.4% of NMOSD patients infected with COVID‐19 had asymptomatic or mild forms, with only two patients (2.6%) requiring hospitalization. None of these patients required tracheal intubation or admission to the intensive care unit. Clinical symptoms were found to be more prevalent in HC groups. Additionally, the HC groups had higher fever‐recorded temperatures. NMOSD patients who received hUC‐MSCs treatment had shorter disease duration than patients who did not receive hUC‐MSCs treatment. Discussion Immunosuppressant‐treated patients with NMOSD have a similar risk of COVID‐19 infection as the general population, but the disease duration is shorter and the clinical symptoms are less severe. Among our NMOSD patients who received hUC‐MSCs treatment, COVID‐19 outcomes were favorable, with no increased risk of severe COVID‐19. Prospective studies on immunotherapies are needed to help determine best treatment practices.
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spelling doaj-art-09c58dd45d2d4477adf16ef620baa3e02025-08-20T03:24:11ZengWileyImmunity, Inflammation and Disease2050-45272024-01-01121n/an/a10.1002/iid3.1128Immunosuppressive therapy and COVID‐19 infection in patients with NMOSDUn Wai Choi0Xiwen Ai1Hongyan Li2Yong Hao3Xiaoying Yao4Yangtai Guan5Department of Neurology, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Neurology, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Neurology, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Neurology, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Neurology, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Neurology, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaAbstract Introduction To evaluate whether treated with immunosuppressants in neuromyelitis optica spectrum disorder (NMOSD) shows an effect on the severity and outcomes of COVID‐19 Omicron variant. Methods This is a substudy of a single‐center clinical trial involving human umbilical cord mesenchymal stem cells (hUC‐MSCs) in NMOSD patients. NMOSD patients with hUC‐MSCs treatment, NMOSD patients without hUC‐MSCs treatment, and matched healthy controls (HC) were included. Demographic information, NMOSD‐related clinical features, comorbidities, use of disease‐modifying therapy, COVID‐19 vaccination status, COVID‐19 clinical features, COVID‐19 clinical outcomes, and NMOSD‐related disease activity were obtained through online questionnaires or phone calls. Results The majority of NMOSD patients received long‐term treatment with mycophenolate mofetil (68.8%) or azathioprine (22.9%), and 50% received oral glucocorticoid. During the epidemic, 97.4% of NMOSD patients infected with COVID‐19 had asymptomatic or mild forms, with only two patients (2.6%) requiring hospitalization. None of these patients required tracheal intubation or admission to the intensive care unit. Clinical symptoms were found to be more prevalent in HC groups. Additionally, the HC groups had higher fever‐recorded temperatures. NMOSD patients who received hUC‐MSCs treatment had shorter disease duration than patients who did not receive hUC‐MSCs treatment. Discussion Immunosuppressant‐treated patients with NMOSD have a similar risk of COVID‐19 infection as the general population, but the disease duration is shorter and the clinical symptoms are less severe. Among our NMOSD patients who received hUC‐MSCs treatment, COVID‐19 outcomes were favorable, with no increased risk of severe COVID‐19. Prospective studies on immunotherapies are needed to help determine best treatment practices.https://doi.org/10.1002/iid3.1128COVID‐19human umbilical cord mesenchymal stem cell (hUC‐MSC)immunosuppressantneuromyelitis optica spectrum disorder (NMOSD)
spellingShingle Un Wai Choi
Xiwen Ai
Hongyan Li
Yong Hao
Xiaoying Yao
Yangtai Guan
Immunosuppressive therapy and COVID‐19 infection in patients with NMOSD
Immunity, Inflammation and Disease
COVID‐19
human umbilical cord mesenchymal stem cell (hUC‐MSC)
immunosuppressant
neuromyelitis optica spectrum disorder (NMOSD)
title Immunosuppressive therapy and COVID‐19 infection in patients with NMOSD
title_full Immunosuppressive therapy and COVID‐19 infection in patients with NMOSD
title_fullStr Immunosuppressive therapy and COVID‐19 infection in patients with NMOSD
title_full_unstemmed Immunosuppressive therapy and COVID‐19 infection in patients with NMOSD
title_short Immunosuppressive therapy and COVID‐19 infection in patients with NMOSD
title_sort immunosuppressive therapy and covid 19 infection in patients with nmosd
topic COVID‐19
human umbilical cord mesenchymal stem cell (hUC‐MSC)
immunosuppressant
neuromyelitis optica spectrum disorder (NMOSD)
url https://doi.org/10.1002/iid3.1128
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