Accelerated early progression of amyotrophic lateral sclerosis over the covid-19 pandemic

Fabiola De Marchi, Chiara Gallo, Maria Francesca Sarnelli, Ilaria De Marchi, Massimo Saraceno, Roberto Cantello, Letizia Mazzini

Research output: Contribution to journalArticlepeer-review

Abstract

During the COVID-19 pandemic and the related lockdowns, outpatient follow-up visits for patients with chronic neurological diseases have been suspended. Managing people affected by amyotrophic lateral sclerosis (ALS) has become highly complicated, leaving patients without the standard multidisciplinary follow-up. This study aimed to analyze the impact of the COVID-19 lockdown on ALS disease progression. We compared the clinical data and progression in the first year following diagnosis for patients who received ALS diagnosis during 2020 (G20, N = 34), comparing it with a group of diagnosed in 2018 (G18, N = 31). Both groups received a comparable multidisciplinary model of care in our Tertiary Expert ALS Centre, Novara, Italy. The monthly rate of ALSFRS-R decline during the lockdown was significantly increased in G20 compared to G18 (1.52 ± 2.69 vs. 0.76 ± 0.56; p-value: 0.005). In G20, 47% required non-invasive ventilation (vs. 32% of G18). Similarly, in G20, 35% of patients died vs. 19% of patients in G18 (p-value: 0.01). All results were corrected for gender, age, site of onset, and diagnostic delay. Several factors can be implicated in making ALS more severe, with a faster progression, such as reduced medical evaluations and the possibility of therapeutic changes, social isolation, and rehabilitation therapy suspension.

Original languageEnglish
Article number1291
JournalBrain Sciences
Volume11
Issue number10
DOIs
Publication statusPublished - Oct 2021

Keywords

  • ALSFRS-R
  • Amyotrophic lateral sclerosis
  • COVID-19
  • Motoneuron disease
  • Pandemic
  • Progression

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