Abstract：
BACKGROUND: Coronavirus disease 2019 (COVID-19) can not only infect the respiratory system but also affect the nervous system through the release of inflammatory factors. Our study aimed to investigate the effect of COVID-19 infection on cerebral adrenoleukodystrophy (ALD).
METHODS: Changes in the neurological symptoms of cerebral ALD after infection with COVID-19 from January 2022 to February 2023 were retrospectively analyzed. The primary assessment indicator was the Neurologic Function Scale (NFS) score.
RESULTS: A total of 17 male patients with cerebral ALD were enrolled, with a median age of 101 months (80 to 151 months). Among them, 11 (11 of 17, 64.7%) developed an exacerbation of neurological symptoms after COVID-19 infection. Two patients with NFS = 0 started presenting with neurological symptoms after infection. Fifteen patients were in the advanced stage (NFS >1 and/or Loes score >9), of which nine did not progress to major functional disabilities (MFDs). Seven of the nine patients (77.8%) experienced an increase in NFS scores, ranging from 1 to 9 points, within two weeks of COVID-19 infection, with four of them experiencing MFDs. For the other six patients who had progressed to MFDs, there was not much room for further degeneration, so the NFS score did not increase after COVID-19 infection. No deaths related to COVID-19 infection occurred.
CONCLUSIONS: COVID-19 infection may aggravate neurological symptoms of cerebral ALD, particularly among patients who have not yet progressed to MFDs. Therefore, COVID-19 may accelerate the course of cerebral ALD, so protecting patients from infection is essential for maintaining the stability of the disease.
METHODS: Changes in the neurological symptoms of cerebral ALD after infection with COVID-19 from January 2022 to February 2023 were retrospectively analyzed. The primary assessment indicator was the Neurologic Function Scale (NFS) score.
RESULTS: A total of 17 male patients with cerebral ALD were enrolled, with a median age of 101 months (80 to 151 months). Among them, 11 (11 of 17, 64.7%) developed an exacerbation of neurological symptoms after COVID-19 infection. Two patients with NFS = 0 started presenting with neurological symptoms after infection. Fifteen patients were in the advanced stage (NFS >1 and/or Loes score >9), of which nine did not progress to major functional disabilities (MFDs). Seven of the nine patients (77.8%) experienced an increase in NFS scores, ranging from 1 to 9 points, within two weeks of COVID-19 infection, with four of them experiencing MFDs. For the other six patients who had progressed to MFDs, there was not much room for further degeneration, so the NFS score did not increase after COVID-19 infection. No deaths related to COVID-19 infection occurred.
CONCLUSIONS: COVID-19 infection may aggravate neurological symptoms of cerebral ALD, particularly among patients who have not yet progressed to MFDs. Therefore, COVID-19 may accelerate the course of cerebral ALD, so protecting patients from infection is essential for maintaining the stability of the disease.
摘要：
背景：2019年冠状病毒病（COVID-19）不仅可以感染呼吸系统，还可以通过释放炎症因子影响神经系统。我们的研究旨在研究COVID-19感染对脑肾上腺脑白质营养不良（ALD）的影响。
方法：回顾性分析2022年1月至2023年2月COVID-19感染后脑ALD的神经症状变化。主要评估指标为神经功能量表（NFS）评分。
结果：共纳入17例脑ALD男性患者，年龄中位数为101个月（80至151个月）。其中,11人（17人中的11人，64.7%）在COVID-19感染后出现神经系统症状恶化。两名NFS=0的患者在感染后开始出现神经系统症状。15例患者处于晚期（NFS>1和/或Loes评分>9），其中9个没有进展为重大功能障碍(MFD)。9名患者中有7名（77.8％）的NFS评分增加，1到9分，在COVID-19感染两周内，其中四个人正在经历MFD。对于其他六名进展为MFD的患者，没有太多进一步退化的空间，因此，感染COVID-19后NFS评分没有增加。没有发生与COVID-19感染相关的死亡。
结论：COVID-19感染可加重脑ALD的神经症状，特别是在尚未进展为MFDs的患者中.因此,COVID-19可能加速脑ALD的进程，因此，保护患者免受感染对于维持疾病的稳定至关重要。
方法：回顾性分析2022年1月至2023年2月COVID-19感染后脑ALD的神经症状变化。主要评估指标为神经功能量表（NFS）评分。
结果：共纳入17例脑ALD男性患者，年龄中位数为101个月（80至151个月）。其中,11人（17人中的11人，64.7%）在COVID-19感染后出现神经系统症状恶化。两名NFS=0的患者在感染后开始出现神经系统症状。15例患者处于晚期（NFS>1和/或Loes评分>9），其中9个没有进展为重大功能障碍(MFD)。9名患者中有7名（77.8％）的NFS评分增加，1到9分，在COVID-19感染两周内，其中四个人正在经历MFD。对于其他六名进展为MFD的患者，没有太多进一步退化的空间，因此，感染COVID-19后NFS评分没有增加。没有发生与COVID-19感染相关的死亡。
结论：COVID-19感染可加重脑ALD的神经症状，特别是在尚未进展为MFDs的患者中.因此,COVID-19可能加速脑ALD的进程，因此，保护患者免受感染对于维持疾病的稳定至关重要。
