Serum inflammatory markers as predictors of neurological status in patients with stroke in the course of hypertension: a two-center study

Introduction. Every year, 60.000 people have stroke incidents in Poland. Despite the fact that it can be prevented, stroke remains the leading cause of morbidity and mortality worldwide. Hypertension is one of the leading risk factors for the stroke incident. The aim was to assess the relationship between inflammatory markers and clinical status of hypertensive patients with the stroke. Material and methods. 713 patients with stroke in the course of hypertension from the Departments of Neurology in Bytom and Zabrze were enrolled in the retrospective study. They were divided into groups: N1, R1 (with improvement in NIHSS and Rankin results, respectively) and N2, R2 (with deterioration or no changes in NIHSS and Rankin between the day of admission and discharge). Results. The majority of patients were females [%] (51.5 vs 48.5). Women were significantly older than man [years] (78.0 vs 69.0, P = 0.001, respectively) and had higher NIHSS results at admission [points] (6.0 vs 5.0, P = 0.001, respectively). There were significant differences in the serum CRP [mg/l] (4.75 vs 9.40, P = 0.001) and WBC [103/μL] (8.58 vs 9.02, P = 0.006) between N1 and N2, respectively and between R1 and R2: WBC (8.50 vs 9.00, P = 0.006) and CRP (4.20 vs 8.70, P = 0.001), respectively. A significant correlation between CRP and NIHSS on admission was observed (R = 0.191, P < 0.05). NIHSS and Rankin score on admission were correlated with age (R = 0.212, and R = 0.231, P < 0.05, respectively). CRP was related with the volume [cm3] of lesions in CT (R = 0.170, P < 0.05). Conclusions. Inflammation seems to be associated with the worse neurological status of patients with stroke and hypertension. Age and sex affect the clinical course of stroke. CRP may indicate the size of changes in CT

Symptoms after COVID-19 infection in individuals with multiple sclerosis in Poland

(1) Background: To report and analyze the presence of residual symptoms after SARS-CoV-2 infection among Polish patients with multiple sclerosis (MS) treated with different disease-modifying therapies (DMTs). (2) Methods: The study included 426 individuals with MS treated with DMTs and confirmed SARS-CoV-2 infection from 12 Polish MS centers. The data were collected through to 31 May 2021. The information included demographics, specific MS characteristics, course of SARS-CoV-2 infection, and residual (general and neurological) symptoms lasting more than four and 12 weeks after the initial infection. The results were obtained using maximum likelihood estimates for odds ratio and logistic regression. (3) Results: A total of 44.84% patients with MS reported symptoms lasting between four and 12 weeks after the initial infection; 24.41% people had symptoms that resolved up to 12 weeks, and 20.42% patients had symptoms that lasted over 12 weeks. The most common symptoms were: fatigue, disturbance of concentration, attention, and memory, cognitive complaints, and headache. None of the DMTs were predisposed to the development of residual symptoms after the initial infection. A total of 11.97% of patients had relapse three months prior or after SARS-CoV-2 infection. (4) Conclusion: Almost half of individuals with MS treated with different DMTs had residual symptoms after SARS-CoV-2 infection. None of the DMTs raised the probability of developing post-acute COVID symptoms

Analysis of side effects following vaccination against COVID-19 among individuals with multiple sclerosis treated with DMTs in Poland

BACKGROUND AND OBJECTIVES: Since vaccination against COVID-19 is available for over a year and the population of immunized individuals with autoimmune disorders is higher than several months before, an evaluation of safety and registered adverse events can be made. We conducted a large study of side effects following the COVID-19 vaccine among patients with multiple (MS) sclerosis treated with disease-modifying therapies (DMTs) and analyzed factors predisposing for particular adverse events. METHODS: We gathered data of individuals with MS treated with DMTs from 19 Polish MS Centers, who reported at least one adverse event following COVID-19 vaccination. The information was obtained by neurologists using a questionnaire. The same questionnaire was used at all MS Centers. To assess the relevance of reported adverse events, we used Fisher's exact test, t-test, and U-Menn-Whutney test. RESULTS: A total of 1,668 patients with MS and reports of adverse events after COVID-19 vaccination were finally included in the study. Besides one case marked as “red flag”, all adverse events were classified as mild. Pain at the injection site was the most common adverse event, with a greater frequency after the first dose. Pain at the injection site was significantly more frequent after the first dose among individuals with a lower disability (EDSS ≤2). The reported adverse events following immunization did not differ over sex. According to age, pain at the injection site was more common among individuals between 30 and 40 years old, only after the first vaccination dose. None of the DMTs predisposed for particular side effects. CONCLUSIONS: According to our findings, vaccination against COVID-19 among patients with MS treated with DMTs is safe. Our study can contribute to reducing hesitancy toward vaccination among patients with MS