Characteristics of COVID-19 disease in multiple sclerosis patients

Barzegar, Mahdi; Mirmosayyeb, Omid; Ghajarzadeh, Mahsa; Nehzat, Nasim; Vaheb, Saeed; Shaygannejad, Vahid; Vosoughi, Reza

doi:10.1016/j.msard.2020.102276

Cited by 30 publications

(42 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Also, in a report from Isfahan on 543 patients with MS, 66 patients were suspected of having COVID-19, and one rituximab-consuming patient had developed a severe course of COVID-19 disease. However, the authors did not mention anything about the patient's comorbidities ( Barzegar et al., 2020 ). In the current study, although the rate of hospitalization was not related to the type of medication, the two patients who died both were rituximab users.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of the rate of COVID-19 infection, hospitalization and death among Iranian patients with multiple sclerosis

Sahraian

Azimi

Navardi

et al. 2020

Multiple Sclerosis and Related Disorders

100

View full text Add to dashboard Cite

Background: COVID-19 is increasingly expanding all over the world. People who have an underlying disease or taking immunosuppressive drugs are generally more likely to be infected than the others. Multiple sclerosis (MS) patients may also be at risk of the disease and its complications depending on the medication they are taking. In this study, we evaluated a large population of patients with MS with different disease modifying drugs to show if any of them increases the risk. In addition, this study evaluates the incidence of COVID-19 in patients with MS, the rate of hospitalization or death in these patients. Method: This study was performed at the MS Clinic of Sina Hospital. All patients were contacted and their demographic characteristics were recorded. They were then asked about their COVID-19 symptoms. Patients with these symptoms were further evaluated. The documents were reviewed by treating neurologist and MS nurses to be sure about diagnosis of COVID19. The positive polymerase chain reaction (PCR) result or compatible lung computed tomography (CT) scan was acceptable for COVID-19 diagnosis. Results: 4647 patients answered the phone contact. Of these, 68 were infected with the COVID-19. The rate of hospitalization was 25% which is far more than general population. Two patients died from COVID-19. Rituximab was associated with increase rate of COVID-19 infection but not with hospitalization rate. There was no significant correlation between use of other drugs and rate of infection. Conclusion: This study revealed that the incidence of COVID-19 in MS patients is not more than general population, but the risk of hospitalization in these patients is higher than estimated for the disease. This highlights the importance of communicating to patients the severity of COVID-19 and the importance of risk reduction behaviors like social distancing and mask use.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The medications history of study population during the COVID-19 pandemic. However, the authors did not mention anything about the patient's comorbidities (Barzegar et al, 2020). In the current study, although the rate of hospitalization was not related to the type of medication, the two patients who died both were rituximab users.…”

Section: Tablementioning

confidence: 99%

Evaluation of the rate of COVID-19 infection, hospitalization and death among Iranian patients with multiple sclerosis

Sahraian

Azimi

Navardi

et al. 2020

Multiple Sclerosis and Related Disorders

100

View full text Add to dashboard Cite

show abstract

“…Generally, phase III trials on IFN-b did not reveal an elevated risk of infections [54][55][56]. The MS patients with SARS-CoV-2 infection and IFN-b treatment that have been reported to date experienced a mild disease course [57]. To our knowledge, of the published larger cohorts with a positive SARS-CoV-2 PCR, seven patients were on IFN-b treatment, one needed hospitalization and none required intensive care unit (ICU) treatment or died [58][59][60][61][62].…”

Section: Interferon Bmentioning

confidence: 99%

Immunology of COVID‐19 and disease‐modifying therapies: The good, the bad and the unknown

Zrzavy

Wimmer

Rommer

et al. 2020

Euro J of Neurology

View full text Add to dashboard Cite

The outbreak of the SARS‐CoV‐2 pandemic, caused by a previously unknown infectious agent, posed unprecedented challenges to healthcare systems and unmasked their vulnerability and limitations worldwide. Patients with long‐term immunomodulatory/suppressive therapies, as well as their physicians, were and are concerned about balancing the risk of infection and effects of disease‐modifying therapy. Over the last few months, knowledge regarding SARS‐CoV‐2 has been growing tremendously, and the first experiences of infections in patients with multiple sclerosis (MS) have been reported. This review summarizes the currently still limited knowledge about SARS‐CoV‐2 immunology and the commonly agreed modes of action of approved drugs in immune‐mediated diseases of the central nervous system (MS and neuromyelitis optica spectrum disorder). Specifically, we discuss whether immunosuppressive/immunomodulatory drugs may increase the risk of SARS‐CoV‐2 infection and, conversely, may decrease the severity of a COVID‐19 disease course. At present, it can be recommended in general that none of those therapies with a definite indication needs to be stopped per se . A possibly increased risk of infection for most medications is accompanied by the possibility to reduce the severity of COVID‐19. Despite the knowledge gain over the last few months, current evidence remains limited, and, thus, further clinical vigilance and systematic documentation is essential.

show abstract

“…1), suggesting that most MS treatments that largely exhibit limited persistent effects on the innate immune and CD8 T cell responses would have limited influence on COVID‐19. SARS‐CoV‐2 is eliminated by the majority of people with MS and other autoimmunities on immunotherapies, without significant consequences [34–56] (Table 1). Anti‐viral antibodies, notably those targeting the receptor binding domain of the viral spike protein, clearly neutralize the virus [57,58] and can contribute to the elimination of the primary SARS‐CoV‐2 infection in humans [58,59].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 vaccine-readiness for anti-CD20-depleting therapy in autoimmune diseases

Baker

Roberts

Pryce

et al. 2020

Clinical and Experimental Immunology

171

201

View full text Add to dashboard Cite

Based on the known and emerging biology of autoimmune diseases and COVID‐19, it was hypothesised that whilst B‐cell depletion should not necessarily expose people to severe SARS‐CoV‐2‐related issues, it may inhibit or blunt the protective immunity following infection and vaccination. This is supported clinically, as the majority of SARS‐CoV‐2 infected, CD20‐depleted people with autoimmunity, have recovered. However, in CD‐20 treated people until naïve B‐cells repopulate, based on B‐cell repopulation‐kinetics and vaccination responses, from published rituximab, and unpublished ocrelizumab (NCT00676715, NCT02545868) trial data shown here suggests that it may be possible to undertake dose‐interruption to maintain inflammatory disease control, whilst allowing effective vaccination against SARS‐CoV‐29, if and when an effective vaccine is available.

show abstract

Characteristics of COVID-19 disease in multiple sclerosis patients

Cited by 30 publications

References 11 publications

Evaluation of the rate of COVID-19 infection, hospitalization and death among Iranian patients with multiple sclerosis

Evaluation of the rate of COVID-19 infection, hospitalization and death among Iranian patients with multiple sclerosis

Immunology of COVID‐19 and disease‐modifying therapies: The good, the bad and the unknown

COVID-19 vaccine-readiness for anti-CD20-depleting therapy in autoimmune diseases

Contact Info

Product

Resources

About