Introduction

Factors influencing self-perceived health status over Corona Virus Disease 2019 (COVID-19) emergency in vulnerable populations, such as patients with chronic neurological diseases, are still unknown. In this work, we aimed at testing whether clinical care changes imposed by the quarantine, together with certain demographic and disease-specific features, might have determined a self-perceived worsening of health status in patients with amyotrophic lateral sclerosis (ALS).

Methods

A brief web-based questionnaire investigating self-perceived anxiety, depression, and motor worsening, as well as clinical care changes over COVID-19 emergency, was administered to ALS patients currently followed at San Martino Hospital. Ordinal and logistic regression analyses were applied to identify significant predictors of health status.

Results

Fifty-seven ALS patients completed the questionnaire. A total of 35.08% of cases reported anxiety symptoms, 36.84% depressive symptoms, and 35.08% reported worsening of motor symptoms. Significant predictors of anxiety symptoms severity included female gender, greater motor impairment, more aggressive disease course, and rehabilitation therapy suspension. The only significant predictor of depressive symptoms severity was a more aggressive disease course. Significant predictors of motor worsening were shorter disease duration and exams/visits cancelation.

Discussion

COVID-19 emergency and its management exerted a significant impact on self-perceived health status in patients with ALS, particularly in those cases in the earliest disease phases and with a more aggressive disease course. These findings have potential to improve personalized medicine strategies in the next phase.

中文翻译：

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ALS 患者因 COVID-19 紧急情况而自我感知健康状况恶化的预测因素

介绍

影响弱势群体（例如患有慢性神经系统疾病的患者）在 2019 年冠状病毒病（COVID-19）紧急情况下自我感知健康状况的因素仍不清楚。在这项工作中，我们旨在测试隔离带来的临床护理变化以及某些人口统计和疾病特定特征是否可能决定肌萎缩侧索硬化症（ALS）患者自我感知的健康状况恶化。

方法

对目前在圣马蒂诺医院进行随访的 ALS 患者进行了一份简短的网络调查问卷，调查了自我感知的焦虑、抑郁和运动恶化，以及 COVID-19 紧急情况下的临床护理变化。应用序数和逻辑回归分析来确定健康状况的重要预测因素。

结果

57 名 ALS 患者完成了调查问卷。共有35.08%的病例报告焦虑症状，36.84%报告抑郁症状，35.08%报告运动症状恶化。焦虑症状严重程度的重要预测因素包括女性、更大的运动障碍、更具侵袭性的病程和康复治疗暂停。抑郁症状严重程度的唯一显着预测因素是更具侵袭性的病程。运动恶化的重要预测因素是病程缩短和检查/就诊取消。

讨论

COVID-19 紧急情况及其管理对 ALS 患者的自我感知健康状况产生了重大影响，特别是在那些处于疾病最早阶段和病程更具侵袭性的病例中。这些发现有可能改善下一阶段的个性化医疗策略。