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Deenen JCW, Kools J, Greco A, Thewissen R, van de Put W, Lanser A, Joosten LAB, Verbeek ALM, van Engelen BGM, Voermans NC. Living with facioscapulohumeral muscular dystrophy during the first two COVID-19 outbreaks: a repeated patient survey in the Netherlands. Acta Neurol Belg 2024; 124:559-566. [PMID: 38218752 DOI: 10.1007/s13760-023-02443-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/20/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Patients with facioscapulohumeral dystrophy (FSHD) suffer from slowly progressive muscle weakness. Approximately 20% of FSHD patients end up wheelchair-dependent. FSHD patients benefit from physical activity to maintain their muscle strength as much as possible. The impact of the COVID-19 pandemic on the health of FSHD patients was unknown. OBJECTIVE This study assessed changes in daily care received, perceived psychosocial stress, and worsening of FSHD complaints in 2020. Furthermore, we compared COVID-19 infection incidence and severity of symptoms between FSHD patients and non-FSHD housemates. METHODS Three online survey rounds were sent out to all adult participants of the Dutch FSHD registry regarding daily care received, perceived psychosocial stress, COVID-19 infection rate, and COVID-19 symptoms severity. They also included COVID-19-related questions regarding the participants' housemates, which served as control group. RESULTS Participation rate was 210 (61%), 186 (54%), and 205 (59%) for survey 1, 2, and 3, respectively. Care reduction was reported by 42.7%, 40%, and 28.8% of the participants in the respective surveys. Perceived psychosocial stress increased in 44%, 30%, and 40% of the participants. Compared to the 197 non-FSHD housemates, the 213 FSHD patients reported more possibly COVID-19-related symptoms (27% vs. 39%, p = 0.017) of mostly minimal severity (63%). No difference in (possible) COVID-19 infection incidence rates was found (2.0% vs. 2.8%, p = 0.527). CONCLUSIONS The COVID-19 pandemic negatively impacted care received and increased perceived psychosocial stress in FSHD patients. However, COVID-19 infection incidence in FSHD patients was similar to their non-FSHD housemates.
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Affiliation(s)
- Johanna C W Deenen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department for Health Evidence, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Joost Kools
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Anna Greco
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Internal Medicine, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Renée Thewissen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Wiecke van de Put
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Anke Lanser
- Patient Representative and Chairman FSHD Advocacy Group, Patient Organization for Muscular Disease Spierziekten Nederland, Lt. Gen. van Heutszlaan 6, 3743 JN, Baarn, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Strada Victor Babeș 8, 400347, Cluj-Napoca, Romania
| | - Andre L M Verbeek
- Department for Health Evidence, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Baziel G M van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Salsi V, Vattemi GNA, Tupler RG. The FSHD jigsaw: are we placing the tiles in the right position? Curr Opin Neurol 2023; 36:455-463. [PMID: 37338810 PMCID: PMC10487374 DOI: 10.1097/wco.0000000000001176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common myopathies, involving over 870,000 people worldwide and over 20 FSHD national registries. Our purpose was to summarize the main objectives of the scientific community on this topic and the moving trajectories of research from the past to the present. RECENT FINDINGS To date, research is mainly oriented toward deciphering the molecular and pathogenetic basis of the disease by investigating DUX4-mediated muscle alterations. Accordingly, FSHD drug development has been escalating in the last years in an attempt to silence DUX4 or to block its downstream effectors. Breakthroughs in the field include the awareness that new biomarkers and outcome measures are required for tracking disease progression and patient stratification. The need to develop personalized therapeutic strategies is also crucial according to the phenotypic variability observed in FSHD subjects. SUMMARY We analysed 121 literature reports published between 2021 and 2023 to assess the most recent advances in FSHD clinical and molecular research.
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Affiliation(s)
- Valentina Salsi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena
| | - Gaetano Nicola Alfio Vattemi
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy
| | - Rossella Ginevra Tupler
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena
- Department of Molecular Cell and Cancer Biology
- Li Weibo Institute for Rare Diseases Research at the University of Massachusetts Medical School, Worcester, USA
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Ilic Zivojinovic J, Djurdjevic K, Bozovic I, Meola G, Peric M, Azanjac Arsic A, Basta I, Rakocevic-Stojanovic V, Peric S. Myotonic dystrophy type 1 in the COVID-19 era. Neurol Sci 2023:10.1007/s10072-023-06834-5. [PMID: 37155112 PMCID: PMC10165299 DOI: 10.1007/s10072-023-06834-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 04/28/2023] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Myotonic dystrophy type 1 (DM1) is the most prevalent muscular dystrophy in adults. People with DM1 might represent a high-risk population for respiratory infections, including COVID-19. Our aim was to evaluate the characteristics of COVID-19 infection and vaccination rate in DM1 patients. METHODS This cross-sectional cohort study included 89 patients from the Serbian registry for myotonic dystrophies. Mean age at testing was 48.4 ± 10.4 years with 41 (46.1%) male patients. Mean duration of the disease was 24.0 ± 10.3 years. RESULTS COVID-19 infection was reported by 36 (40.4%) DM1 patients. Around 14% of patients had a more severe form of COVID-19 requiring hospitalization. The severity of COVID-19 was in accordance with the duration of DM1. A severe form of COVID-19 was reported in 20.8% of patients who were not vaccinated against SARS-CoV-2 and in none of the vaccinated ones. The majority of 89 tested patients (66.3%) were vaccinated against SARS-CoV-2. About half of them (54.2%) received three doses and 35.6% two doses of vaccine. Mild adverse events after vaccination were recorded in 20.3% of patients. CONCLUSIONS The percentage of DM1 patients who suffered from COVID-19 was like in general population, but with more severe forms in DM1, especially in patients with longer DM1 duration. The study indicated an overall favorable safety profile of COVID-19 vaccines among individuals with DM1 and its ability to protect them from severe COVID-19.
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Affiliation(s)
- Jelena Ilic Zivojinovic
- Institute of Hygiene and Medical Ecology, University of Belgrade - Faculty of Medicine, Belgrade, Serbia
| | - Katarina Djurdjevic
- Institute of Hygiene and Medical Ecology, University of Belgrade - Faculty of Medicine, Belgrade, Serbia
| | - Ivo Bozovic
- University Clinical Center of Serbia - Neurology Clinic, University of Belgrade - Faculty of Medicine, Belgrade, Serbia
| | - Giovanni Meola
- Department of Neurorehabilitation Sciences, Casa Di Cura Igea, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Marina Peric
- Mother and Child Health Care Institute "Dr. Vukan Cupic", Belgrade, Serbia
| | - Ana Azanjac Arsic
- Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Ivana Basta
- University Clinical Center of Serbia - Neurology Clinic, University of Belgrade - Faculty of Medicine, Belgrade, Serbia
| | - Vidosava Rakocevic-Stojanovic
- University Clinical Center of Serbia - Neurology Clinic, University of Belgrade - Faculty of Medicine, Belgrade, Serbia
| | - Stojan Peric
- University Clinical Center of Serbia - Neurology Clinic, University of Belgrade - Faculty of Medicine, Belgrade, Serbia.
- Department for Neuromuscular Disorders, Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 6, Dr Subotic Street, Belgrade, 11 000, Serbia.
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Abstract
PURPOSE OF REVIEW The global spread of severe acute respiratory syndrome coronavirus 2 resulted in many cases of acute and postacute muscular symptoms. In this review, we try to decipher the potential underlying pathomechanisms and summarize the potential links between viral infection and muscle affection. RECENT FINDINGS Disregarding single case studies that do not allow safe conclusions due to the high number of infections, histopathological evidence of myositis has only been reported in deceased individuals with severe COVID-19. Postacute myalgia and weakness seem to occur in a subset of patients up to one year after initial infection, reminiscent of postinfectious syndromes (PIS) described in prior epidemics and pandemics of the past. SUMMARY COVID-19 associated myopathy likely comprises different entities with heterogeneous pathomechanisms. Individual factors such as disease severity and duration, age, sex, constitutional susceptibilities, and preexisting conditions are important to consider when formulating a diagnosis. Persisting symptoms show overlapping features with PIS or postintensive care syndrome. In lack of strong evidence for a direct infection of myocytes, inflammatory myopathies associated with COVID-19 are presumably immune-mediated. Differential diagnosis of rheumatological and nonmuscular neurological origin coinciding with the infection need to be considered, due to the extremely high numbers of newly occurring infections the last 2 years.
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Affiliation(s)
- Tom Aschman
- Department of Neuropathology, Charité - Universitätsmedizin, Berlin, Germany
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