RT Journal Article
SR Electronic
T1 SARS-CoV-2 Infection in Multiple Sclerosis
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e1024
DO 10.1212/NXI.0000000000001024
VO 8
IS 5
A1 Georgina Arrambide
A1 Miguel Ángel Llaneza-González
A1 Lucienne Costa-Frossard França
A1 Virginia Meca-Lallana
A1 Eva Fernández- Díaz
A1 Irene Moreno-Torres
A1 Jose Manuel García-Domínguez
A1 Gloria Ortega-Suero
A1 Lucía Ayuso-Peralta
A1 Mayra Gómez-Moreno
A1 Javier J. Sotoca-Fernández
A1 Ana Belén Caminero-Rodríguez
A1 Luis A. Rodríguez de Antonio
A1 Marcial Corujo-Suárez
A1 María A. Otano-Martínez
A1 Francisco Carlos Pérez-Miralles
A1 Virginia Reyes-Garrido
A1 Teresa Ayuso-Blanco
A1 José Jesús Balseiro-Gómez
A1 Mercedes Muñoz-Pasadas
A1 Inmaculada Pérez-Molina
A1 Carmen Arnal-García
A1 Ángela Domingo-Santos
A1 Cristina Guijarro-Castro
A1 Cristina Íñiguez-Martínez
A1 Nieves Téllez Lara
A1 Fernando Castellanos-Pinedo
A1 Tamara Castillo-Triviño
A1 Debora María Cerdán-Santacruz
A1 Ángel Pérez-Sempere
A1 Berta Sebastián Torres
A1 Amaya Álvarez de Arcaya
A1 Eva Costa-Arpín
A1 Eduardo Durán-Ferreras
A1 Marta Fragoso-Martínez
A1 Montserrat González-Platas
A1 Lamberto Landete Pascual
A1 Jorge Millán-Pascual
A1 Celia Oreja-Guevara
A1 José E. Meca-Lallana
YR 2021
UL http://nn.neurology.org/content/8/5/e1024.abstract
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