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      Are Type 1 Interferons treatment in Multiple Sclerosis as a potential therapy against COVID-19?

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Highlights

          • COVID-19 is a pandemic caused by the SARS-Cov-2 coronavirus.

          • The pneumonia caused by COVID-19 may cause high mortality.

          • Treatment and/or vaccination for virus is an ongoing proccess, they have not been discovered yet.

          • Interferons could be effective for the treatment of COVID-19.

          • Further studies of the experiences of people with MS who take type I interferons, such as beta interferons who get COVID-19, will help to inform.

          Abstract

          Background

          : The Coronavirus (COVID-19), (Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)) has been spreading worldwide since its first identification in China. It has been speculated that patients with comorbidities and elderly patients could be at high risk for the pandemic reasoned respiratory insufficiency and death. At first, it was thought that the patients who use immunmodulator therapy could be even at higher risks of disease complications. However, it has been also speculated about that using immunmodulators could be an advantage for the clinical prognosis. Therefore, several immunmodulators are currently being tested as potential treatment for COVID-19.

          Methods

          : In this paper we report on a patient that has been treated with type 1 interferon for multiple sclerosis who developed COVID-19.

          Results

          : Despite using immunmodulator, the symptoms of the patient at hospitalization were mild and he did not show elevated D-dimer, and there was no lymphopenia. He was discharged to home-quarantine with no symptoms.

          Discussion

          : This report supports the idea of using type 1 interferon in the treatment could be effective in COVID-19 affected patients.

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          Most cited references5

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            An Italian programme for COVID-19 infection in multiple sclerosis

            Italy was the first European country to encounter the effects of the coronavirus disease 2019 (COVID-19) pandemic. 1 For people with multiple sclerosis, the situation carries additional reasons for concern. Although emerging work suggests that some coexisting diseases, such as hypertension, might increase the severity of the COVID-19 infection, how less common conditions, such as multiple sclerosis, effect COVID-19 outcomes is still uncertain. Furthermore, immunosuppressive therapies, the mainstay of treatment for multiple sclerosis, might confer additional risks or, on the contrary, confer some protection. Therefore, collecting information to evaluate the relationship between multiple sclerosis and COVID-19 and implement immediate and appropriate protective strategies is crucial. Less crucial, but equally as important, are questions about the long-term effect of this pandemic on psychiatric comorbidities, such as depression and anxiety (common comorbidities in multiple sclerosis), the patient–physician relationship, the spread of scientific information, the development of new models of care, and the role of patients and patient organisations in the community. The Italian Multiple Sclerosis Society (AISM), the Italian Multiple Sclerosis Foundation (FISM), and the Multiple Sclerosis Study Group of the Italian Neurological Society have set up a programme to help with these crucial elements in the response to COVID-19 in patients with multiple sclerosis. The programme was developed according to suggestions received from a group of neurologists, including health-care workers on the front-line and representatives of the AISM and the FISM. Further initiatives of the programme will also consider the results of an online survey made by the AISM and the FISM aimed at understanding the most pressing needs of people with multiple sclerosis during this pandemic. Here we report the results of the pilot phase of an investigation of COVID-19 among people with multiple sclerosis, based on a core set of data collected from treatment providers through a specifically designed web-based case report form. The core data set includes clinical and demographic characteristics, and information on disease-modifying therapies. To be included, patients had to have symptoms and signs of COVID-19 infection, with or without a positive test (RT-PCR on nasal and pharyngeal swabs). On March 14, 2020, we sent the case report form to more than 200 Italian neurologists from about 90 multiple sclerosis centres across Italy. As of April 7, 2020, we have collected data on 232 patients from 38 centres, 57 of whom tested positive for COVID-19 and 175 of whom had suspected COVID-19 symptoms but did not have a positive test (appendix p 1). Mean follow-up was 12·6 days (SD 7·4). The severity of COVID-19 infection in 232 patients was classified as mild (no pneumonia or mild pneumonia) in 223 (96%), severe (shortness of breath, respiratory rates ≥30 breaths per min, blood oxygen saturation ≤93%, PaO2:FiO2 50% within 24–48 h) in four (2%), and critical (respiratory failure, septic shock, and multiple organ dysfunction or failure) in six (3%). 2 Of the six critical patients, one recovered and five died; all had a positive swab (appendix p 2). 21 patients had undergone a 5-day course of methylprednisolone within 3 months before the onset of COVID-19. These results appear to be slightly reassuring and do not seem to contradict guidelines that we and others had already issued on the management of multiple sclerosis treatments in the time of the COVID-19 pandemic. 3 These data must be considered only preliminary, however, and there is not enough information to speculate about any susceptibility to protection from COVID-19 afforded by disease-modifying therapies. The same is true for the effect of comorbidities, sex, and other medications (beyond just the disease-modifying therapies) that patients with multiple sclerosis might be taking. We will continue to monitor these patients throughout the duration of the pandemic. When a system to record all patients with multiple sclerosis positive for COVID-19 is implemented, more data on the prevalence of these cases can be gathered. Our web-based platform for data collection is available to all colleagues interested in collecting this type of data. Through procedures that are currently being defined, we also aim to make the raw consolidated data from this web-based case report form open access.
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              SARS-CoV-2 sensitive to type I interferon pretreatment

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                Author and article information

                Contributors
                Journal
                Mult Scler Relat Disord
                Mult Scler Relat Disord
                Multiple Sclerosis and Related Disorders
                Elsevier B.V.
                2211-0348
                2211-0356
                16 May 2020
                16 May 2020
                : 102196
                Affiliations
                [a ]Department of Internal Medicine, Ankara City Hospital, Ankara, TURKEY
                [b ]Department of Family Medicine, Ankara City Hospital, Ankara, TURKEY
                [c ]Department of Internal Medicine and Division of Rheumatology, Ankara City Hospital, Ankara, TURKEY
                Author notes
                [* ]Corresponding author. egemcioglu@ 123456gmail.com
                Article
                S2211-0348(20)30272-8 102196
                10.1016/j.msard.2020.102196
                7228888
                32480326
                921aeead-926f-4e0f-b028-6d9c36831335
                © 2020 Elsevier B.V. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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