PT  - JOURNAL ARTICLE
AU  - Arrambide, Georgina
AU  - Llaneza-González, Miguel Ángel
AU  - Costa-Frossard França, Lucienne
AU  - Meca-Lallana, Virginia
AU  - Díaz, Eva Fernández-
AU  - Moreno-Torres, Irene
AU  - García-Domínguez, Jose Manuel
AU  - Ortega-Suero, Gloria
AU  - Ayuso-Peralta, Lucía
AU  - Gómez-Moreno, Mayra
AU  - Sotoca-Fernández, Javier J.
AU  - Caminero-Rodríguez, Ana Belén
AU  - Rodríguez de Antonio, Luis A.
AU  - Corujo-Suárez, Marcial
AU  - Otano-Martínez, María A.
AU  - Pérez-Miralles, Francisco Carlos
AU  - Reyes-Garrido, Virginia
AU  - Ayuso-Blanco, Teresa
AU  - Balseiro-Gómez, José Jesús
AU  - Muñoz-Pasadas, Mercedes
AU  - Pérez-Molina, Inmaculada
AU  - Arnal-García, Carmen
AU  - Domingo-Santos, Ángela
AU  - Guijarro-Castro, Cristina
AU  - Íñiguez-Martínez, Cristina
AU  - Téllez Lara, Nieves
AU  - Castellanos-Pinedo, Fernando
AU  - Castillo-Triviño, Tamara
AU  - Cerdán-Santacruz, Debora María
AU  - Pérez-Sempere, Ángel
AU  - Torres, Berta Sebastián
AU  - Álvarez de Arcaya, Amaya
AU  - Costa-Arpín, Eva
AU  - Durán-Ferreras, Eduardo
AU  - Fragoso-Martínez, Marta
AU  - González-Platas, Montserrat
AU  - Landete Pascual, Lamberto
AU  - Millán-Pascual, Jorge
AU  - Oreja-Guevara, Celia
AU  - Meca-Lallana, José E.
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