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