NMOSD Patients Reflect General Public in COVID-19 Knowledge, Attitudes, Iranian Study Finds

People with neuromyelitis optica spectrum disorder (NMOSD) have similar knowledge and attitudes about COVID-19 as the overall population, an Iranian study suggests.

The findings highlight several areas where better education about COVID-19 is warranted, the researchers wrote.

Their study, “Assessment of mental health, knowledge, and attitude of patients with multiple sclerosis and neuromyelitis optica spectrum disorder in response to 2019 novel coronavirus,” was published in Neurological Sciences.

NMOSD is a progressive autoimmune disease that is characterized by inflammation in the nervous system. As such, people with the disease are often given treatments to suppress the immune system, making them more vulnerable to infectious diseases like COVID-19.

Widespread education about COVID-19 infection, its effects, and how it can be prevented is needed to effectively control the spread of the virus. To design such programs, it is important to understand current attitudes and knowledge.

In the new study, Iranian researchers surveyed four groups, including 41 people with NMOSD and 223 with multiple sclerosis (MS), an autoimmune neurodegenerative disorder. For comparison purposes, the study also included 29 people who experienced migraines, and 245 with no known health conditions.

The researchers collected demographic and health-related data from the survey respondents, and information about their mental health. The respondents were also asked questions about their knowledge of COVID-19, and attitudes toward the virus.

No significant differences were found among the groups in terms of demographics (age, sex, marital status, etc.). The mean disease duration between MS and NMOSD was significantly different (6.4 vs 3.78 years).

Attitudes and knowledge about COVID-19 were not significantly different among the groups. For example, most respondents in all groups could correctly identify the most common symptoms of the disease from a list.

“No substantial difference in knowledge and attitude regarding the new coronavirus disease and attitude among the study groups was found,” the researchers wrote.

Of note, statistical analyses generally did not suggest significant associations between clinical factors and knowledge of/attitudes toward COVID-19. The only exception was that people with physical comorbidities (the presence of one or more additional conditions in addition to a primary condition) were significantly more likely to have a more negative attitude about the pandemic.

“Our results show that symptoms of psychological illness, awareness, and belief about COVID-19 had no association with clinical courses, disease severity, duration of disease, and psychological comorbidity,” the researchers wrote.

The results highlighted some noteworthy gaps in knowledge. For example, in all groups, over 70% of respondents incorrectly believed that antibiotics can help treat COVID-19. Antibiotics kill bacteria, not viruses like in the case of COVID-19 infections.

“It is strongly recommended that some educational programs should be conducted to improve knowledge of patients about the efficacy of antibiotic treatment in new coronavirus,” the researchers wrote.

Additionally, while masks were widely believed to be effective for preventing the spread of COVID-19, about 15% of respondents across the groups had poor knowledge about the role of social distancing to prevent COVID-19 transmission.

“Healthcare systems and clinicians should persuade patients to observe social distancing,” the researchers wrote.

However, nearly 80% of MS and NMOSD respondents believed that avoiding contact with COVID-19 patients was necessary to control and manage the disease, and about 90% of these groups agreed that most patients recovered.

More than half (58.5%) of NMOSD patients in the study said that their primary source of information about COVID-19 was social media.

“With the COVID-19 outbreak, myths and fake news have rapidly spread on social media,” the researchers wrote.

“Therefore, healthcare systems and governments [ought to] provide authentic information and encourage people to avoid the spread of fake news,” they added.

This study is limited by the reliance on self-reported data, as well as the fact that the surveys were conducted online, limiting participation only to people with internet access.

“Notwithstanding these limitations, as far as we know, this paper is the first to study the knowledge, attitude, and mental health status in MS and NMOSD patients within the COVID-19 pandemic,” the researchers concluded. “The current data highlight the necessity of attitude, knowledge, and mental health assessment among MS and NMOSD patients.”

“Further studies in other countries need to be carried to assess these points among MS and NMOSD patients,” they added.