RIZIK OD COVID-19 INFEKCIJE KOD BOLESNIKA SA MULTIPLOM SKLEROZOM LEČENIH OKRELIZUMABOM – ISKUSTVO JEDNOG CENTRA
Sažetak
Okrelizumab je terapija koja modifikuje prirodni tok bolesti u multiploj sklerozi (MS) i koristi se za lečenje aktivne relapsno remitentne i/ili primarno progresivne forme bolesti. Tokom pandemije virusa COVID-19 spekulisalo se da bi okrelizumab mogao povećati rizik od infekcije izazvane viursom COVID-19 kod bolesnika sa MS. Cilj rada je procena rizika od COVID-19 infekcije kod obolelih od multiple skleroze i lečenih okrelizumabom. Našom studijom obuhvaćeni su bolesnici koji su ispunjavali revidirane McDonald kriterijume, a koji su lečeni okrelizumabom u Univerzitetskom kliničkom centru Niš. Dijagnoza COVID-19 infekcije postavljena je pozitivnim PCR (lančanom reakcijom polimeraze) ili antigenskim testom. Težina COVID-19 infekcije procenjena je na osnovu australijskih smernica za kliničku negu osoba zaraženih COVID-19 viursom. Od 103 pacijenta lečena okrelizumabom, kod njih 33 utvrđeno je da su zaraženi COVID-19. Od toga je bilo 10 (30,3 %) pozitivnih muškaraca i 23 (69,7 %) žene. Prosečna starost obolelih bila je 43,9 godina ± 9,1 godina. Većina njih imala je blagu kliničku sliku COVID-19 infekcije (81,8%); 12,1% imao je umereno tešku kliničku sliku, 3% tešku kliničku manifestaciju, a jedan pacijent je preminuo. Nije bilo značajnog uticaja primene okrelizumaba kod bolesnika sa MS na povećan rizik od infekcije COVID-19 virusom i razvoj teške kliničke manifestacije bolesti. U našoj kohorti, bolesnici sa umerenom i teškom kliničkom slikom COVID-19 infekcije obično su bili stariji od 50 godina (66,7%), mada tih bolesnika nije bilo mnogo.
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