Long sessions of coronavirus disease 2019 (COVID-19) lockdown and self-imposed restrictions have created a negative impact on patients with degenerative diseases such as Parkinson's disease.¹ Similarly, patients with degenerative cerebellar ataxia (CA) are also at risk for contracting COVID-19 infection and its complications, such as long-term COVID sequelae, referred to as “post-COVID-19 syndrome” or “long COVID.”^{2, 3} Currently, there is no published report on the effects of COVID-19 and post-COVID-19 syndrome in patients with CA. Here, we report our observations on the impact of COVID-19 in 102 genetically confirmed patients with spinocerebellar ataxia 12 (SCA12), which is one of the most common forms of hereditary ataxia in North India.⁴ During the COVID-19-related lockdown period from April 2021 to June 2021, the patients were followed up routinely via telephone. We conducted a structured telephone interview to identify the implications and outcomes of COVID-19 using a questionnaire prepared by movement disorder experts.

Of 102 patients, 28% (29; 21 male and 8 female) were infected with COVID-19 (COVID-19-SCA12). The mean age and disease duration at interview were 59.73 (SD ± 10.02) and 8.0 (SD ± 4.63) years, respectively. Demography, other characteristics, COVID-19-related issues, and outcomes among COVID-19-positive and -negative patients with SCA12 are listed in Table 1. About 83% of all patients with SCA12 had received at least one dose of COVID-19 vaccine. Among patients with COVID-19-SCA12, deterioration of gait, tremors, slurred speech, and weakness were reported by 27.5%, 17%, 7%, and 10%, respectively, during the pandemic. Daily activities were performed independently by 66% of patients, while 24% needed support. Hypertension (21%) and diabetes (31%) dominated as comorbid illnesses. History of contact with COVID-19-infected family members or workplace cohabitants was confirmed by 31% of patients. Hospitalization was required in 24%, while 76% of patients recovered in home isolation. The most frequent COVID symptoms were low-grade fever (90%), weakness (90%), and coughing (41%). The majority of patients (92%) recovered within 4 weeks of onset of COVID-19 symptoms. Three patients died in the hospital. Two patients experienced post-COVID complications: one experienced short-term memory loss, and the other had a temporary confused mental state.

The frequency of covid-19 infection in our SCA 12 patients was not very different (28% vs. 24.1%) from national seroprevalence data of the general population in India.⁵ High vaccination rate in patients with SCA12 could be attributed to their living in relatively larger cities, their higher education level, and their older age, which made them eligible for early vaccination.⁶ The phenotype of SARS-CoV-2 infection in our patients with SCA12 concur with existing literature on the most prevalent COVID-19 symptoms in the general adult population.⁷ Recovery of patients with COVID-19-SCA12 matched with acute COVID-19 timelines.³

We believe that prolonged confinement to homes and disruption in rehabilitation sessions may have contributed to the worsening of ataxic symptoms in patients with SCA12. We could not compare the frequencies of COVID-19-SCA12 and their immunization with the general population of the same mean age group because the age-group-wise data on the prevalence of COVID-19 is still evolving in India.

In conclusion, patients with COVID-19-SCA12 fared similarly as those without COVID-19 during the pandemic, and COVID-19 outcomes in patients with SCA12 were comparable with COVID-19 in the general population. Therefore, they can be treated with the same protocol and care that is given to patients with general COVID-19. It may be useful to evaluate the impact of COVID-19 on other types of common CAs (SCA1 and SCA2), with rapid progression and severe outcomes having subclinical pulmonary dysfunction.

2019 年冠状病毒病 (COVID-19) 的长期封锁和自我限制对帕金森病等退行性疾病患者产生了负面影响。¹同样，退行性小脑性共济失调 (CA) 患者也有感染 COVID-19 及其并发症的风险，例如长期 COVID 后遗症，称为“COVID-19 后综合征”或“长期 COVID”。^{2, 3}目前，还没有关于 COVID-19 和 COVID-19 后综合征对 CA 患者影响的已发表报告。在这里，我们报告了我们对 COVID-19 对 102 名经基因证实的脊髓小脑性共济失调 12 (SCA12) 患者的影响的观察结果，这是印度北部最常见的遗传性共济失调形式之一。⁴在 2021 年 4 月至 2021 年 6 月的与 COVID-19 相关的封锁期间，通过电话定期对患者进行随访。我们使用运动障碍专家准备的问卷进行了结构化电话采访，以确定 COVID-19 的影响和结果。

在 102 名患者中，28%（29 名；21 名男性和 8 名女性）感染了 COVID-19（COVID-19-SCA12）。访谈时的平均年龄和病程分别为 59.73 (SD ± 10.02) 和 8.0 (SD ± 4.63) 年。表 1 列出了 SCA12 的 COVID-19 阳性和阴性患者的人口统计学、其他特征、COVID-19 相关问题和结果。所有 SCA12 患者中约有 83% 接受过至少一剂 COVID-19疫苗。在 COVID-19-SCA12 患者中，大流行期间步态恶化、震颤、言语不清和虚弱的报告率分别为 27.5%、17%、7% 和 10%。66% 的患者独立进行日常活动，而 24% 的患者需要支持。高血压 (21%) 和糖尿病 (31%) 作为合并症占主导地位。31% 的患者确认了与感染 COVID-19 的家庭成员或工作场所同居者的接触史。24% 的患者需要住院治疗，而 76% 的患者在家隔离中康复。最常见的 COVID 症状是低烧 (90%)、虚弱 (90%) 和咳嗽 (41%)。大多数患者 (92%) 在出现 COVID-19 症状后 4 周内康复。三名患者在医院死亡。两名患者出现了 COVID 后并发症：一名出现了短期记忆丧失，另一名出现了暂时的精神错乱。大多数患者 (92%) 在出现 COVID-19 症状后 4 周内康复。三名患者在医院死亡。两名患者出现了 COVID 后并发症：一名出现了短期记忆丧失，另一名出现了暂时的精神错乱。大多数患者 (92%) 在出现 COVID-19 症状后 4 周内康复。三名患者在医院死亡。两名患者出现了 COVID 后并发症：一名出现了短期记忆丧失，另一名出现了暂时的精神错乱。

我们的 SCA 12 患者中 covid-19 感染的频率与印度一般人群的全国血清阳性率数据没有很大不同（28% 对 24.1%）。⁵ SCA12 患者的高疫苗接种率可能归因于他们居住在相对较大的城市、较高的文化程度和年龄较大，这使得他们有资格进行早期疫苗接种。⁶我们的 SCA12 患者的 SARS-CoV-2 感染表型与现有文献中关于一般成年人群中最普遍的 COVID-19 症状的文献一致。⁷与急性 COVID-19 时间线相匹配的 COVID-19-SCA12 患者的康复情况。³

我们认为，长期居家隔离和康复治疗中断可能导致 SCA12 患者共济失调症状恶化。我们无法将 COVID-19-SCA12 的频率及其免疫接种与相同平均年龄组的一般人群进行比较，因为关于 COVID-19 流行率的年龄组数据在印度仍在不断发展。

总之，COVID-19-SCA12 患者在大流行期间的表现与没有 COVID-19 的患者相似，SCA12 患者的 COVID-19 结果与一般人群中的 COVID-19 相当。因此，他们可以使用与一般 COVID-19 患者相同的方案和护理进行治疗。评估 COVID-19 对其他类型的常见 CA（SCA1 和 SCA2）的影响可能有用，这些 CA 进展迅速，严重后果具有亚临床肺功能障碍。