SARS-CoV-2 Infection in Multiple Sclerosis

Abstract

ObjectiveTo understand COVID-19 characteristics in people with multiple sclerosis (MS) and identify high-risk individuals due to their immunocompromised state resulting from the use of disease-modifying treatments.MethodsRetrospective and multicenter registry in patients with MS with suspected or confirmed COVID-19 diagnosis and available disease course (mild = ambulatory; severe = hospitalization; and critical = intensive care unit/death). Cases were analyzed for associations between MS characteristics and COVID-19 course and for identifying risk factors for a fatal outcome.ResultsOf the 326 patients analyzed, 120 were cases confirmed by real-time PCR, 34 by a serologic test, and 205 were suspected. Sixty-nine patients (21.3%) developed severe infection, 10 (3%) critical, and 7 (2.1%) died. Ambulatory patients were higher in relapsing MS forms, treated with injectables and oral first-line agents, whereas more severe cases were observed in patients on pulsed immunosuppressors and critical cases among patients with no therapy. Severe and critical infections were more likely to affect older males with comorbidities, with progressive MS forms, a longer disease course, and higher disability. Fifteen of 33 patients treated with rituximab were hospitalized. Four deceased patients have progressive MS, 5 were not receiving MS therapy, and 2 were treated (natalizumab and rituximab). Multivariate analysis showed age (OR 1.09, 95% CI, 1.04–1.17) as the only independent risk factor for a fatal outcome.ConclusionsThis study has not demonstrated the presumed critical role of MS therapy in the course of COVID-19 but evidenced that people with MS with advanced age and disease, in progressive course, and those who are more disabled have a higher probability of severe and even fatal disease.

Symptoms after COVID-19 Infection in Individuals with Multiple Sclerosis in Poland

“…Beyond prolonged symptoms, every point of EDSS significantly increased the chance for hospitalization in our cohort. A similar observation was made by other MS centers [37]. The statistical difference in the occurrence of residual symptoms between RRMS and progressive phenotypes of the disease was not significant.…”

Impact of COVID-19 pandemic on frequency of clinical visits, performance of MRI studies, and therapeutic choices in a multiple sclerosis referral centre

“…MS therapy approach during the COVID-19 pandemic has been and still remains a challenge for MS neurologists trying to balance benefits and risks. Prescription of lympho-depleting agents in MS has been a matter of discussion due to the association with COVID-19 susceptibility and outcome risks [ 7 , 29 , 30 ]. Indeed, a survey has recently reported that 23% of centres avoided such therapies, whereas 8% postponed any type of DMD in treatment naïve-patients during the first months of the pandemic [ 25 ].…”

COVID-19 severity among patients with multiple sclerosis treated with cladribine: A systematic review and meta-analysis

“…Of the remaining 114, 7 were selected for the final analysis, along with 6 retrieved out from search strategy (Figure 1). References of 13 selected manuscripts 6,7,9,16,17,18,19,20,21,22,23,24 are shown in Table 1.…”