PT - JOURNAL ARTICLE AU - Georgina Arrambide AU - Miguel Ángel Llaneza-González AU - Lucienne Costa-Frossard França AU - Virginia Meca-Lallana AU - Eva Fernández- Díaz AU - Irene Moreno-Torres AU - Jose Manuel García-Domínguez AU - Gloria Ortega-Suero AU - Lucía Ayuso-Peralta AU - Mayra Gómez-Moreno AU - Javier J. Sotoca-Fernández AU - Ana Belén Caminero-Rodríguez AU - Luis A. Rodríguez de Antonio AU - Marcial Corujo-Suárez AU - María A. Otano-Martínez AU - Francisco Carlos Pérez-Miralles AU - Virginia Reyes-Garrido AU - Teresa Ayuso-Blanco AU - José Jesús Balseiro-Gómez AU - Mercedes Muñoz-Pasadas AU - Inmaculada Pérez-Molina AU - Carmen Arnal-García AU - Ángela Domingo-Santos AU - Cristina Guijarro-Castro AU - Cristina Íñiguez-Martínez AU - Nieves Téllez Lara AU - Fernando Castellanos-Pinedo AU - Tamara Castillo-Triviño AU - Debora María Cerdán-Santacruz AU - Ángel Pérez-Sempere AU - Berta Sebastián Torres AU - Amaya Álvarez de Arcaya AU - Eva Costa-Arpín AU - Eduardo Durán-Ferreras AU - Marta Fragoso-Martínez AU - Montserrat González-Platas AU - Lamberto Landete Pascual AU - Jorge Millán-Pascual AU - Celia Oreja-Guevara AU - José E. Meca-Lallana TI - SARS-CoV-2 Infection in Multiple Sclerosis AID - 10.1212/NXI.0000000000001024 DP - 2021 Sep 01 TA - Neurology - Neuroimmunology Neuroinflammation PG - e1024 VI - 8 IP - 5 4099 - http://nn.neurology.org/content/8/5/e1024.short 4100 - http://nn.neurology.org/content/8/5/e1024.full SO - Neurol Neuroimmunol Neuroinflamm2021 Sep 01; 8 AB - Objective To 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.Methods Retrospective 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.Results Of 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.Conclusions This 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.ANOVA=analysis of variance; CI=confidence interval; DMT=disease-modifying treatment; EDSS=Expanded Disability Status Scale; ICU=intensive care unit; IQR=interquartile range; IVMP=IV pulses of methylprednisolone; MS=multiple sclerosis; OR=odds ratio; RT=real time; SARS-CoV-2=severe acute respiratory syndrome coronavirus 2