COVID-19 Among Patients With Multiple Sclerosis

Abstract

ObjectiveWe systematically reviewed the literature on COVID-19 in patients with multiple sclerosis (MS).MethodsWe searched PubMed, Scopus, EMBASE, CINAHL, Web of Science, Google Scholar, and World Health Organization database from December 1, 2019, to December 18, 2020. Three conference abstract databases were also searched. We included any types of studies that reported characteristics of patients with MS with COVID-19.ResultsFrom an initial 2,679 publications and 3,138 conference abstracts, 87 studies (67 published articles and 20 abstracts) consisting of 4,310 patients with suspected/confirmed COVID-19 with MS met the inclusion criteria. The female/male ratio was 2.53:1, the mean (SD) age was 44.91 (4.31) years, the mean disease duration was 12.46 (2.27), the mean Expanded Disability Status Scale score was 2.54 (0.81), the relapsing/progressive ratio was 4.75:1, and 32.9% of patients had at least 1 comorbidity. The most common symptoms were fever (68.8%), followed by cough (63.9%), fatigue/asthenia (51.2%), and shortness of breath (39.5%). In total, 837 of 4,043 patients with MS with suspected/confirmed COVID-19 (20.7%) required hospitalization, and 130 of 4,310 (3.0%) died of COVID-19. Among suspected/confirmed patients, the highest hospitalization and mortality rates were in patients with no disease-modifying therapies (42.9% and 8.4%), followed by B cell–depleting agents (29.2% and 2.5%).ConclusionOur study suggested that MS did not significantly increase the mortality rate from COVID-19. These data should be interpreted with caution as patients with MS are more likely female and younger compared with the general population where age and male sex seem to be risk factors for worse disease outcome.

COVID-19 mRNA vaccination leading to CNS inflammation: a case series

“…In late 2019, an outbreak due to a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the coronavirus disease 2019 (COVID-19) global pandemic and claimed many lives, especially in patients with comorbidities [ 1 ]. Early reports suggested that individuals with multiple sclerosis (MS) had an increased risk for a worse outcome after contracting COVID-19, based on certain disease characteristics and treatments [ 2 – 4 ] while other studies disputed these claims [ 5 – 7 ]. A recent study suggested no significant effects on MS relapse rates after COVID-19 infection [ 8 ].…”

The Immunological Therapeutic Strategies for Controlling Multiple Sclerosis: Considerations during the COVID-19 Pandemic

“…In a recent systematic review, the most common symptoms of COVID-19 in patients with MS were as follows: fever (68.8%), cough (63.9%), fatigue/asthenia (51.2%), and dyspnea (39.5%) [ 65 ]. In total, only 5.3% of patients were asymptomatic.…”

“…Again, it should be noted that diseased patients receiving B-cell-depleting therapies were also at higher ages and presented a severe degree of disability. Notwithstanding, more established investigations are required [ 65 , 67 ].…”

“…Accordingly, published data suggest that MS may not significantly increase the mortality rate of COVID-19. There was no significant difference between the severity and mortality of COVID-19 in patients with MS and the general population [ 65 , 68 ]. Bsteh and colleagues announced that the proportion of patients with MS at high risk of COVID-19 mortality is under 1% [ 69 ].…”

“…The mean (SD) age, mean disease duration, and mean Expanded Disability Status Scale score were 44.91 (4.31) years, 12.46 (2.27) years, and 2.54 (0.81), respectively. At least one comorbidity was seen in 32.9% of patients [ 65 ].…”