PDF(Pubmed)
Abstract：
People with Multiple Sclerosis (PwMS) are vulnerable to unfavorable occupational outcomes and the COVID-19 pandemic brought major consequences on people\'s professional lives. In this view, we decided to investigate the occupational outcomes of PwMS during the COVID-19 pandemic.
We performed a systematic review with meta-analysis searching key terms in four databases. We initially included any peer-reviewed original article that enrolled adult patients with the diagnosis of MS and assessed any occupational variable during the COVID-19 pandemic. There were no time limits and no language restrictions. The primary outcomes were the prevalence of unemployment, retirement and employment status change among people with MS during the COVID-19 pandemic. Other outcomes included the modality and characteristics of work: type of work, full-time work, part-time work and remote work. We also searched for data from studies that addressed any change in the work status due to the COVID-19 outbreak.
We identified 49 eligible articles comprising a total sample size of 17,364 individuals with MS. The pooled prevalence of unemployment and retirement was 0.47 (95% CI = 0.42-0.53). The pooled prevalence of PwMS who were unemployed or retired was positively associated with the progressive phenotype of the disease (p = 0.017) and the use of glatiramer acetate (p = 0.004), but negatively associated with hospitalization due to COVID-19 (p = 0.008) and the use of immunosuppressants (p = 0.032), siponimod (p < 0.001), and cladribine (p = 0.021). The pooled proportion of PwMS that reported any change of the employment status during the COVID-19 pandemic was 0.43 (95% CI = 0.36-0.50) while the pooled prevalence of PwMS who worked remotely during this period was 0.37 (95% CI = 0.15-0.58). The change in employment status was negatively associated with the duration of MS (p = 0.03) but positively associated with the progressive phenotype of the disease (p < 0.001).
Our seminal review may serve as an example of how patients with neurological diseases or disabilities in general may have their jobs impacted in a pandemic and foster the context of global socio-economic crisis.
We performed a systematic review with meta-analysis searching key terms in four databases. We initially included any peer-reviewed original article that enrolled adult patients with the diagnosis of MS and assessed any occupational variable during the COVID-19 pandemic. There were no time limits and no language restrictions. The primary outcomes were the prevalence of unemployment, retirement and employment status change among people with MS during the COVID-19 pandemic. Other outcomes included the modality and characteristics of work: type of work, full-time work, part-time work and remote work. We also searched for data from studies that addressed any change in the work status due to the COVID-19 outbreak.
We identified 49 eligible articles comprising a total sample size of 17,364 individuals with MS. The pooled prevalence of unemployment and retirement was 0.47 (95% CI = 0.42-0.53). The pooled prevalence of PwMS who were unemployed or retired was positively associated with the progressive phenotype of the disease (p = 0.017) and the use of glatiramer acetate (p = 0.004), but negatively associated with hospitalization due to COVID-19 (p = 0.008) and the use of immunosuppressants (p = 0.032), siponimod (p < 0.001), and cladribine (p = 0.021). The pooled proportion of PwMS that reported any change of the employment status during the COVID-19 pandemic was 0.43 (95% CI = 0.36-0.50) while the pooled prevalence of PwMS who worked remotely during this period was 0.37 (95% CI = 0.15-0.58). The change in employment status was negatively associated with the duration of MS (p = 0.03) but positively associated with the progressive phenotype of the disease (p < 0.001).
Our seminal review may serve as an example of how patients with neurological diseases or disabilities in general may have their jobs impacted in a pandemic and foster the context of global socio-economic crisis.
摘要：
■多发性硬化症（PwMS）患者容易受到不利的职业结果的影响，COVID-19大流行给人们的职业生活带来了重大后果。在这个观点中,我们决定调查COVID-19大流行期间PwMS的职业结局.
■我们在四个数据库中使用荟萃分析搜索关键术语进行了系统综述。我们最初纳入了任何同行评审的原始文章，这些文章招募了诊断为MS的成年患者，并评估了COVID-19大流行期间的任何职业变量。没有时间限制，也没有语言限制。主要结果是失业率，在COVID-19大流行期间，MS患者的退休和就业状况发生变化。其他成果包括工作的方式和特征：工作类型，全职工作,兼职工作和远程工作。我们还搜索了来自研究的数据，这些研究解决了由于COVID-19爆发而导致的工作状态的任何变化。
■我们确定了49篇符合条件的文章，其中包含17,364名女士的总样本量。失业和退休的合并患病率为0.47（95％CI=0.42-0.53）。失业或退休的PwMS的合并患病率与疾病的进行性表型（p=0.017）和醋酸格拉替雷的使用（p=0.004）呈正相关，但与COVID-19（p=0.008）和使用免疫抑制剂（p=0.032）导致的住院呈负相关，西波莫德（p<0.001），和克拉屈滨（p=0.021）。报告COVID-19大流行期间就业状况有任何变化的PwMS合并比例为0.43(95%CI=0.36-0.50)，而在此期间远程工作的PwMS合并患病率为0.37(95%CI=0.15-0.58)。就业状况的变化与MS的持续时间呈负相关（p=0.03），但与疾病的进行性表型呈正相关（p<0.001）。
我们的开创性综述可以作为一个例子，说明神经系统疾病或残疾患者在大流行中如何影响他们的工作，并促进全球社会经济危机的背景。
■我们在四个数据库中使用荟萃分析搜索关键术语进行了系统综述。我们最初纳入了任何同行评审的原始文章，这些文章招募了诊断为MS的成年患者，并评估了COVID-19大流行期间的任何职业变量。没有时间限制，也没有语言限制。主要结果是失业率，在COVID-19大流行期间，MS患者的退休和就业状况发生变化。其他成果包括工作的方式和特征：工作类型，全职工作,兼职工作和远程工作。我们还搜索了来自研究的数据，这些研究解决了由于COVID-19爆发而导致的工作状态的任何变化。
■我们确定了49篇符合条件的文章，其中包含17,364名女士的总样本量。失业和退休的合并患病率为0.47（95％CI=0.42-0.53）。失业或退休的PwMS的合并患病率与疾病的进行性表型（p=0.017）和醋酸格拉替雷的使用（p=0.004）呈正相关，但与COVID-19（p=0.008）和使用免疫抑制剂（p=0.032）导致的住院呈负相关，西波莫德（p<0.001），和克拉屈滨（p=0.021）。报告COVID-19大流行期间就业状况有任何变化的PwMS合并比例为0.43(95%CI=0.36-0.50)，而在此期间远程工作的PwMS合并患病率为0.37(95%CI=0.15-0.58)。就业状况的变化与MS的持续时间呈负相关（p=0.03），但与疾病的进行性表型呈正相关（p<0.001）。
我们的开创性综述可以作为一个例子，说明神经系统疾病或残疾患者在大流行中如何影响他们的工作，并促进全球社会经济危机的背景。
